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Kaiqi Du
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P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)
- 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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P1.01-113 - Analysis of Clinicopathological Features and Clinical Efficacy of Crizotinib in ROS1 Positive Non-Small Cell Lung Cancer (ID 11100)
16:45 - 18:00 | Author(s): Kaiqi Du
- Abstract
Background
ROS1 gene-rearrangement in non-small-cell lung cancer (NSCLC) patients has recently been identified as a driver gene and benefited from crizotinib treatment. The aim of this study is to explore clinicopathological features and clinical efficacy of crizotinib in c-ros oncogene 1 receptor tyrosine kinase (ROS1) positive non-small cell lung cancer (NSCLC).
a9ded1e5ce5d75814730bb4caaf49419 Method
A retrospective analysis of 2617 cases of NSCLC from January 2013 to December 2016, ROS1 fusion gene were detected by real-time reverse transcriptase-polymerase chain reaction (RT-PCR), fluorescent in situ hybridization (FISH) or next-generation sequencing (NGS) technique and part ROS1 fusion gene positive patients were received oral treatment with crizotinib.
4c3880bb027f159e801041b1021e88e8 Result
ROS1 fusion was found in 67 of 2167 cases (2.56%). 21 cases were male and 46 cases were female. The median age was 68 years old. Among these cases, 59 (88.05%) were adenocarcinoma and 8 were non-adenocarcinoma. According the TNM staging,4 cases were Ⅰ-Ⅲa and 63(94.02%) cases were Ⅲb-Ⅳ. EGFR gene status included 60 cases wild type, 1 case co-mutation and 6 cases unknown. There were statistical difference in sex, TNM staging and EGFR gene status between ROS1 fusion gene positive and negetive patients (P<0.001). 23 patients were received oral treatment with crizotinib and PR, SD, PD patients were 13 (56.52%), 5 (21.74%) and 5 (21.74%) respectively. The ORR was 56.52% and DCR was 78.26%. Of all the cases, median PFS was14.5 months and OS was 27.3 months. The one-year PFS was 50.4%.There were no difference of median PFS in age, sex, smoking history, PS score, pathology type, TNM staging ,TP53 gene status, EGFR gene status and the first line crizotinib treatment whether or not by single and multiple factor analysis. The 3/4 grade treatment-related adverse events were gastrointestinal disturbance, followed by increased transaminase.
8eea62084ca7e541d918e823422bd82e Conclusion
The rate of ROS1 fusion of NSCLC is lower. Crizotinib is an effective and safe drug for the treatment of ROS1 positive advanced NSCLC.
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P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.15-06 - Capillary Leak Syndrome in a Primary Lung Adenocarcinoma Patient with Thrombocytopenia from Interleukin-11 Treatment (ID 11104)
12:00 - 13:30 | Author(s): Kaiqi Du
- Abstract
Background
Capillary leak syndrome (CLS) is an uncommon complication characterized by generalized edema and hypotension. We report a 62-year-old male patient with lung and liver metastasis who had underwent liver radiofrequency ablation.
a9ded1e5ce5d75814730bb4caaf49419 Method
He was treated with interleukin (IL)-11 (3 mg per day) because of chemotherapy induced thrombocytopenia.
4c3880bb027f159e801041b1021e88e8 Result
After 9 days of therapy, the patient complained of abdominal distension and with bilateral edema of all four extemities. Chest computed tomography and B ultrasound of the abdomen showed pleural effusions and ascites. IL-11 was then discontinued, fluid resuscitation was performed, fresh frozen plasma and packed red blood cells were transfused, and methylprednisolone therapy was administered. The patient had recovered after 12 days of treatment.
8eea62084ca7e541d918e823422bd82e Conclusion
This case report demonstrates that patients with lung cancer can develop this rare form of CLS after treatment with IL-11. The manifestation of IL-11-induced CLS indicates that it may be a severe side effect of IL-11 treatment in cancer.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.CR - Case Reports (Not CME Accredited Session) (ID 984)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.CR-04 - Lung Cancer with Concurrent ROS1 Rearrangement and KRAS Mutation: A Case Report (ID 11106)
12:00 - 13:30 | Author(s): Kaiqi Du
- Abstract
Background
ROS1 rearrangement has recently emerged as a new molecular subtype in non-small cell lung cancer (NSCLC), and is predominantly found in lung adenocarcinomas compared with other oncogenes such as EGFR, KRAS, or ALK. Patients who have both mutations are extremely rare.
a9ded1e5ce5d75814730bb4caaf49419 Method
A 42-year-old female diagnosed with adenocarcinoma (IIIB, T2N3M0), who was shown to have ROS1 and KRAS mutations by next generation sequencing.
4c3880bb027f159e801041b1021e88e8 Result
The patient was prescribed oral crizotinib and a CT scan show a partial response in the pulmonary lesions after one month. Unfortunately, a CT scan show progression of the pulmonary lesion after three months. And the patient was treated with the MEK inhibitor, selumetinib (AZD6244), combined with pemetrexed. The patient was alive at now.
8eea62084ca7e541d918e823422bd82e Conclusion
We reviewed the related literature to determine the frequency of gene mutations in NSCLC patients. A better understanding of the molecular biology of NSCLC with multiple driver genomic aberrations will assist in determining optimal treatment.
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P3.CR-13 - Dual Drive Coexistence of EML4-ALK Fusion and TPM3-ROS1 Fusion Lung Adenocarcinoma: A Case Report (ID 11092)
12:00 - 13:30 | Author(s): Kaiqi Du
- Abstract
Background
Recent reports of overlap between ROS1 fusions and other oncogenic driver alterations have still been controversial. We reported a case of concomitant EML4-ALK fusion and TPM3-ROS1 in non-small-cell lung cancer (NSCLC) and further reviewed the clinical characteristic in this type double fusion of NSCLC patients.
a9ded1e5ce5d75814730bb4caaf49419 Method
A 47-year-old male diagnosed with adenocarcinoma (IA, T1aN0M0), who was shown to have ALK and ROS1 fusion by next generation sequencing.
4c3880bb027f159e801041b1021e88e8 Result
The patient presented with a locally tumor of the left upper lobe with physical examination. He received lung cancer surgery with thoracoscopic. by using next generation sequencing assay, we found that tumor had concomitant EML4-ALK fusion and TPM3-ROS1. No recurrence was observed from a follow-up of 7 months in the case. Considering this rare ALK fusion and ROS1 double rearranged, we conclude that the incidence of this double mutation in NSCLC patients should be attentive.
8eea62084ca7e541d918e823422bd82e Conclusion
With the guidance of precise diagnosis, it is important that we should realize the incidence of concomitant ROS1 fusion and other driver genes including ALK or EGFR. And it should further explore treatment model and provides additional therapeutic options.
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