Author of

• 18971

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  P1.02 - Biology/Pathology (ID 614)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Biology/Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 22550

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    P1.02-066 - Cancer Stem Cells  in Pulmonary High Grade Neuroendocrine Carcinoma: a Series of 23 Cases from Eastern India (ID 9719)

    09:30 - 16:00  |  Presenting Author(s): Prasanta Raghab Mohapatra
    • Abstract

    Background:
    As per WHO 2015 classification, high grade neuroendocrine carcinomas (HGNEC) [both large cell (LCNEC) and small cell (SCLC)] constitute around 20% of the total lung carcinomas. These tumours are biologically aggressive with early metastasis; have a tendency to recur and develop resistance to conventional chemotherapy. The aggressive behaviour is postulated to be due to the presence of stem cell like cancer cells [cancer stem cell (CSC)].This study was aimed to determine the clinicopathological significance of CSC markers in HGNEC on small lung biopsies.
    
    Method:
    Twenty three cases of HGNEC (7 LCNEC, 16 SCLC) diagnosed over a period of 2 ½ years at AIIMS, Bhubaneswar were analysed retrospectively. Bronchoscopic and transthoracic biopsies were subjected to routine morphological and immunohistochemical analysis by using synaptophysin, chromogranin, CD 56/NCAM, and Mib-1. Subcategorization was done as per WHO 2015 guidelines. CSC markers such as ALDH1, CD 34, and CD 117 were used for further analysis.
    
    Result:
    As followsFigure 1 Figure 2
    
    
    
    
    
    Conclusion:
    A high proportion (16/23, 68%) of HGNECs were positive for at least one CSC marker. ALDH1 expression noted more in LCNEC. Immunohistochemical expression of CSC markers on small biopsies may be used for prognostication and management in pulmonary neuroendocrine carcinomas.
    
    

• 20179

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  P2.15 - SCLC/Neuroendocrine Tumors (ID 716)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: SCLC/Neuroendocrine Tumors
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23517

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    P2.15-002 - Pulmonary Large Cell Neuroendocrine Carcinoma (LCNEC): An Experience From Eastern Indian Hospital (ID 8755)

    09:30 - 16:00  |  Presenting Author(s): Prasanta Raghab Mohapatra
    • Abstract

    Background:
    Neuroendocrine tumors of lung are classified into four histological types (WHO-2015): typical carcinoid, atypical carcinoid, small-cell lung cancer (SCLC) and large cell neuroendocrine carcinoma (LCNEC). The Pulmonary LCNEC is considered as an orphan disease due to its low incidence. Our aim was to evaluate the clinical presentation and outcome of standard chemotherapy for LCNEC. All India Institute of Medical Sciences, Bhubaneswar, is an institute of national importnace situated in eastern India. No case of LCNEC has been reported from this part of India till date.
    
    Method:
    We retrospectively analysed data of patients from June 2014 June to May 2017 with special focus on pulmonary neuroendocrine tumors. We examined incidence of different histological types of pulmonary neuroendocrine tumors. We also analysed clinical characteristics of patients with pulmonary LCNEC and their treatment outcomes.
    
    Result:
    In this new Institution 263 Lung Cancer patients were diagnosed by bronchoscopic and transthoracic biopsies. There were 26 (10%) patients with pulmonary neuroendocrine tumors(NEC). Seven(2.7%) of them were LCNEC, 3(1%) carcinoid and 17 (7%) were SCLC. Median age of pulmonary LCNEC was 60 years with M:F ratio 5:2. Four of them were smokers. Median performance status (ECOG) was 2.5. Three patients presented with superior vena cava obstruction and 5 patients had central mass lesions. All the elligible patients with LCNEC were offered chemotherapy with Cisplatin 60 mg/m [2] IV on day-1 plus etoposide 120 mg/m [2] IV on days 1 to 3 in every 21days for initial 4 cycles as a standard treatment in addition to other supportive care. Two patients could not complete initial 4 cycles of chemotherapy due to progression of the diseases and drug intolerance. Four (57%) of the patients had partial response in initial chemotherapy and subsequent progression of disease. Two patients were offered Topotecan as second line chemotherapy but no significant response was observed. Overall survival of patients of LCNEC was 7 months (4-11).
    
    Conclusion:
    Incidence of pulmonary LCNEC is low but is increasingly encountered. Most of the patients were diagnosed at advanced stages. Overall survival was poor despite chemotherapy. There is no definite second line regimen recommended for LCNEC. There is a need for clinical trial with alternative modalities including targeted and immunological treatment for these types of lung cancer.