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Pierluigi Novellis



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    P1.07 - Immunology and Immunotherapy (ID 693)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      P1.07-032 - 28-Color, 30 Parameter Flow Cytometry to Dissect the Complex Heterogeneity of Tumor Infiltrating T Cells in Lung Cancer (ID 10160)

      09:30 - 16:00  |  Presenting Author(s): Pierluigi Novellis

      • Abstract

      Background:
      Defining the phenotypic, molecular and functional characteristics of tumor infiltrating leukocytes advances our understanding of how the immune system is defective in fighting cancer and may thus lead to the identification of new therapeutic targets to be exploited in the clinic. Considerable heterogeneity is found at the tumor site in terms of leukocyte populations and cellular subsets which may retain pro- or anti-cancer potential. Such heterogeneity can only be addressed by more powerful single cell technologies.

      Method:
      We used 30-parameter single cell flow cytometry to define the memory differentiation, activation, tissue-residency, exhaustion and transcription factor profile of millions of single T cells infiltrating human lung adenocarcinomas.

      Result:
      We revealed that PD-1[high] exhausted T cells were enriched at the tumor site compared to the peripheral blood or to the non-tumoral portion of the lung from the same patient, were mainly confined to the CD69+ tissue-resident memory compartment and expressed high levels of the transcription factor T-bet and the activation marker HLA-DR. Conversely, these PD-1[high] cells were nearly absent from the early-differentiated, circulating memory compartment identified by CCR7+ expression. Bona fide naïve T cells, as identified by the simultaneous expression of 5 markers, were virtually absent at the tumor site. The exhausted T cells also lacked markers of terminally-differentiated senescent T cells, which in turn are CD57+ T-bet[low]Eomes[high], thereby suggesting that exhaustion and senescence are divergent differentiation states.

      Conclusion:
      We anticipate that such high-content single cell profiling will identify patient-specific subpopulations capable to correlate with disease progression and clinical/metabolic parameters.

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    P1.16 - Surgery (ID 702)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.16-027 - Robotic Surgery, VATS, and Open Surgery for Early Stage Lung Cancer: Comparison of Costs and Outcomes at a Single Institute (ID 10227)

      09:30 - 16:00  |  Presenting Author(s): Pierluigi Novellis

      • Abstract

      Background:
      Robotic surgery is increasingly used to resect lung cancer. However costs are high. We compared costs and outcomes for robotic surgery, video-assisted thoracic surgery (VATS), and open surgery, to treat non-small-cell lung cancer (NSCLC).

      Method:
      We retrospectively assessed 103 consecutive patients given lobectomy or segmentectomy for clinical stage I or II NSCLC. Three surgeons could choose VATS or open, the fourth could choose between all three techniques. Between-group differences were assessed by Fisher’s exact, two-way analysis of variance, and Wilcoxon-Mann-Whitney test. P values <0.05 were considered significant.

      Result:
      Twenty-three patients were treated by robot, 41 by VATS, and 39 by open surgery. Age, physical status, pulmonary function, comorbidities, stage, and perioperative complications did not differ between the groups. Pathological tumor size was greater in the open than VATS and robotic groups (P=0.025). Duration of surgery was 150, 191 and 116 minutes, by robotic, VATS and open approaches, respectively (p<0001). Significantly more lymph node stations were removed (p<0.001), and median length of stay was shorter (4, 5 and 6 days, respectively; p<0.001) in the robotic than VATS and open groups. Estimated costs were 82%, 69% and 68%, respectively, of the regional health service reimbursement for robotic, VATS and open approaches.

      Conclusion:
      Robotic surgery for early lung cancer was associated with shorter stay and more extensive lymph node dissection than VATS and open surgery. Duration of surgery was shorter for robotic than VATS. Although the cost of robotic thoracic surgery is high, the hospital makes a profit.