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N.N. Vu



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    P3.02 - Biology/Pathology (ID 620)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 2
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      P3.02-020 - Comparison of Diagnostic Ability for EGFR Mutation of the Specimen Groups: Histology – Cytology – Plasma (ID 7495)

      09:30 - 16:00  |  Author(s): N.N. Vu

      • Abstract
      • Slides

      Background:
      EGFR mutations in NSCLC therapy play a very important role. Currently, many types of specimens are used to perform EGFR mutations. At Pham Ngoc Thach Hospital with RealTime-PCR Technique on cobas [@] z 480 machine has been done on a variety of clinical specimens.

      Method:
      ~- Research with cross sectional descriptive statistics.~ ~- Period from November 2016 to May 2017: 6 months.~ ~- Diagnose EGFR mutations in 3 groups: histology, cytology, plasma.~ ~- Control check with next-generation gene sequencing.~

      Result:
      - Total number research: 56 cases with 26 EGFR mutation (+) with next generation sequencing. - Histology specimens: EGFR (+): 44.64%; Sensitivity: 96.15%, Specificity: 96.67%; Number of cases to be resumed: 0 shifts; Not quantifiable. - Cytology specimens: EGFR (+): 42.86%; Sensitivity: 92.31%; Specificity: 96.67%; Number of cases to be resumed: 2 cases for the second time; Not quantifiable. - Plasma specimen: EGFR (+): 33.93%; Sensitivity: 73.31%; Specificity: 96.55%; Number of cases to be resumed: 12 cases for the second time, 7 cases for the third time; Average mean quantity: 15.66 ± 7.05 ng / μl. → Statement: * Use a variety of specimens to diagnose EGFR mutations. * Sensitivity and detection rates of histological and cytological specimens were higher than plasma samples. * The specificity of these three groups is comparable. * It is not possible to determine when to get the best blood sample for the plasma diagnosis of EGFR mutation. * Plasma samples have the advantage of being semi-quantifiable. So consider predictive factor evaluates the treatment.

      Conclusion:
      * Histology and cytology specimens are more sensitive and detectable than in diagnosis of EGFR mutation. Therefore, this is an important factor in the diagnosis. * Semi quantitative in plasma specimen to monitor treatment response & some cases to diagnose when no re-biopsy is available.

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      P3.02-021 - Secondary EGFR Exon 20 T790m Mutation for Therapy of Non Small Cell Lung Cancer at Phat Ngoc Thach - Ho Chi Minh City - Vietnam (ID 8854)

      09:30 - 16:00  |  Author(s): N.N. Vu

      • Abstract
      • Slides

      Background:
      The EGFR Exon 20 T790M mutation is nowadays widely mentioned in studies on the treatment of non-small cell lung cancer. Especially the secondary mutation T790M or accquired T790M mutation. Aims: I.Investigation of EGFR Exon 20 T790M mutation appears secondary to treatment with targeted therapy or chemotherapy. II.Ability to diagnose EGFR Exon 20 T790M secondary mutation of clinical specimens: Histology - Cytology - Plasma.

      Method:
      * Retrospective study, statistics describing series of clinical cases. * Collect EGFR mutation data in 3 groups: histology, cytology and plasma. * Use RealTime PCR on cobas @ z480 to perform EGFR mutation diagnosis. * All patients have admitted to the hospital. Pham Ngoc Thach with diagnosis of advanced stage non-small cell lung cancer (IIIB and IV) with the following requirements: - They have been treated witht the target therapy or chemotherapy. Then, the disease progresses back to the standard RESIST 1.1. - There has been an initial diagnosis of EGFR mutations. - Diagnosed with mutations in EGFR with samples: histopathology, cytology and plasma.

      Result:
      * Primary EGFR Exon 20 T790M mutation: 7 cases: 4.07%, including 4 simple mutation (2.33%) and 3 combined mutations (1.74%) (Exon 20 T790M + Exon 20 G719X, Exon 20 T790M + Exon 19 Deletion; Exon 20 T790M + Exon 20 S768I). * Secondary EGFR Exon 20 T790M mutation: high rate: 97 cases (56.39%). Compared with other studies in the world, especially in Asia, the values are similar (P = 0.059 - 0.088> 0.05). ⇒ We have been presented the statements: - The EGFR Exon 20 T790M mutation was significantly higher in the primary EGFR mutation group (97 cases vs 7 cases: P = 0.0047 <0.05). - Comparison of mutant EGFR Exon 20 T790M mutation with other studies in the world of the majority showed similar results (P = 0.051 - 0.081> 0.05). - Ability to detect EGFR Exon 20 T790M mutation among 3 groups specimens: Histology - Cytology - Plasma are similar. - With the RealTime PCR technique on plasma samples, it has been helpful in detecting this Exon 20 T790M EGFR mutation.

      Conclusion:
      Secondary EGFR Exon 20 T790M mutations are more likely to be present than in the primary group and predominate in the other secondary EGFR mutations. With the RealTime PCR technique on plasma samples, it has been very helpful in diagnosing this type of mutation.

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