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Likun Hou
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OA03 - Advances in Lung Cancer Pathology (ID 897)
- Event: WCLC 2018
- Type: Oral Abstract Session
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 10:30 - 12:00, Room 205 BD
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OA03.01 - The Immunophenotyping and Genomic Characteristics of Pulmonary Sarcomatoid Carcinoma: Pleomorphic, Spindle Cell and Giant Cell Carcinoma (ID 12239)
10:30 - 10:40 | Author(s): Likun Hou
- Abstract
- Presentation
Background
Pulmonary sarcomatoid carcinoma (PSC) is a poorly differentiated non-small cell lung cancer (NSCLC) and comprises a diagnostically and therapeutically challenging group of tumors. We explored the immunohistochemical characteristics and genetic profiles of PSC (except carcinosarcoma and pulmonary blastoma)
a9ded1e5ce5d75814730bb4caaf49419 Method
A total of 432 cases with surgically resected undifferentiated NSCLC (121 solid adenocarcinomas (ADC), 98 non-keratinizing squamous cell carcinomas (SQC), 118 large cell carcinomas (LCC) and 95 sarcomatoid carcinomas) were reviewed. Expression of epithelial-mesenchymal transition (EMT) markers (Cytokeratin (CK), Vimentin (Vim) and zinc-finger E-box binding homeobox 1 (ZEB1)) were studied by immunohistochemistry. 8 therapeutically-relevant genetic alterations（EGFR/BRAF/KRAS/HER2/MET exon 14 mutations and ALK/ROS1/RET fusion）of sarcomatoid carcinomas were detected by Capture-based targeted sequencing
4c3880bb027f159e801041b1021e88e8 Result
The expression of CK was almost positive in ADC, SQC and LCC, which of sarcomatoid component (SC) of PSC was observed positively only in 80/95(84.2%). Although vim expression was higher (88/95, 92.6%) in SC, it was also positive in ADC (37/121, 30.6%), SQC (14/98, 14.3%), LCC (12/118, 10.2%), respectively. In the contrast, SC was detected with 100% ZEB1 expression in PSC (95/95). ZEB1 expression was focal positive only in 1 cases of SQC (1/98, 1.0%). In ADC and LCC, no ZEB1 expression was found. The expression of ZEB1 had higher specificity (99%) and sensitivity (100%) than Vim expression in SC of PSC. The most frequent mutation genes were KRAS (18/58, 31.0%), EGFR (6/58, 10.3%), MET exon 14 (7/58, 12.0%) and no BRAF/HER2/ALK/ROS1/RET alteration were detected.
8eea62084ca7e541d918e823422bd82e Conclusion
ZEB1 was a useful differential diagnostic marker for PSC. Targeted mutations testing may be useful for classifying and managing PSC patients.
6f8b794f3246b0c1e1780bb4d4d5dc53Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P1.09 - Pathology (Not CME Accredited Session) (ID 941)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.09-10 - Targeted Sequencing of Pulmonary Enteric Adenocarcinoma Reveals Distinctive Mutation Profile from Conventional Type of Lung Adenocarcinoma (ID 12468)
16:45 - 18:00 | Presenting Author(s): Likun Hou
- Abstract
Background
Pulmonary primary enteric adenocarcinoma (PEAD) is a rare subtype of lung cancer, which is defined in the new edition of 2015 WHO classification. However, genetic profiling and information about targeted therapy of PEAD remain unclear.
a9ded1e5ce5d75814730bb4caaf49419 Method
Resected 56 cases of PEAD were retrospectively reviewed. The pathological diagnosis of PEAD was confirmed by immunohistochemistry based on morphology and over 1 year’s follow-up. We use targeted ultra-deep sequencing to test 56 therapeutically relevant genes alterations of PEAD.
4c3880bb027f159e801041b1021e88e8 Result
The majority of PEAD patients were male (41/56, 73.2%). Molecular analysis revealed that KRAS was the most frequently mutated gene (18/56, 32.1%) with no targetable mutation co-existence, and then EGFR (9/56, 16.1%), ERBB2 exon 20 insertion mutations (4/56, 7.1%) and ERBB2 amplification (8/56, 14.3%). 3 cases harboring rare fusion genes were identified, TACC3-FGFR3 (2/56, 3.6%) in 2 cases and CD74-NRG1 in one case, respectively. APC gene mutation was negative in all cases. One postoperative patient with EGFR exon 21 L858R mutation was treated with 4 cycles’ NP chemotherapy regimen. PET-CT found the progression lesion of right rib. Treatment was switched to gefitinib for 8 monthly cycles. Response was poor with brain metastasis. Patient received gamma knife treatment. And then, the results of molecular testing showed no EGFR T790M mutation by using the pleural effusion specimen. Pemetrexed regimen was employed to patient. Follow-up of the patient remains ongoing.
8eea62084ca7e541d918e823422bd82e Conclusion
Pulmonary primary enteric adenocarcinoma exhibited distinctive features of genetic profile. Despite KRAS appearing as the most important mutated gene in PEAD tumors, PEAD patients with sensitive mutations were eligible for targeted therapy.
6f8b794f3246b0c1e1780bb4d4d5dc53
