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Celine Py



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    P1.04 - Immunooncology (Not CME Accredited Session) (ID 936)

    • 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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      P1.04-26 - Prospective Immuno-Biobank in NSCLC (ID 13831)

      16:45 - 18:00  |  Author(s): Celine Py

      • Abstract
      • Slides

      Background

      Immune system could recognize tumor cells and eliminate them. T lymphocytes play an essential role in recognizing and lysing tumor cells. However, the humoral response (antibodies) seems also important. Recently, therapeutically progresses have been obtained with monoclonal antibodies that target inhibitory molecules expressed by T lymphocytes (anti-CTLA4, anti-PD1). Those antibodies induce reactivation or improvement of T lymphocytes’ lysing capacities. This clinical benefit can last for years and has been observed in several types of tumors. This is the beginning of a therapeutic revolution and hundreds of clinical trials are on-going with the objective of better exploitation of this strategy.

      Several steps are needed in order to increase the proportion of patients who benefit from immunotherapies.We currently do not understand completly the reason why an immune response could be efficient or not (spontaneously or after treatment), the respective role and interactions between humoral and cellular responses and mechanisms involved in the development of side effects observed in patients

      a9ded1e5ce5d75814730bb4caaf49419 Method

      All NSCLC patients who are candidate for Immunotherapy treatment regardless of staging and line of treatment cancer will be identified within our oncology department

      Blood sampling will be performed (50 to 100 ml) at severals time points: before any immunotherapy and repeated every 3 months or, in case of side effects or in case of extra-ordinary evolution.

      We will investigate cellular (T lymphocytes) and humoral (B lymphocytes) immune responses. We will also do a sequencing of the tumor in order to investigate genetic alterations. We will question the correlations between immune response and tumor pathological and molecular characteristic’s, as well as the impact of therapies administered to the patients on their immune response.

      4c3880bb027f159e801041b1021e88e8 Result

      We have recruited 12 patients so far, on treatment with immune check point inhibitor. We are going to perform another sampling 3 months after the beginning of the treatment (9 patients at the present time) Currently, we are continuing to reclute patients. The first analysis will be performed once we have 50 patients within the study and presented and the incoming meeting in November 2018

      8eea62084ca7e541d918e823422bd82e Conclusion

      This is, as far as we know, the first prospectiveand ongoing immune- bio-bank in NSCLC patients that is going to provide valuable information to better understand the immunological changing at serological, tissue and genomic level induced by the immunotherapy in NSCLC and the possible mechanism of resistance or progression.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.13 - Targeted Therapy (Not CME Accredited Session) (ID 979)

    • 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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      P3.13-01 - Detecting ALK Rearrangements in NSCLC Patients: IHC, FISH or NGS Fusion? (ID 13344)

      12:00 - 13:30  |  Author(s): Celine Py

      • Abstract
      • Slides

      Background

      Rearrangements of the anaplastic lymphoma kinase (ALK) gene in non-small cell lung cancer (NSCLC) represent a novel molecular target in a small subset of patients. Although ALK rearrangements are usually assessed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), molecular approaches have recently emerged as relevant alternatives in routine laboratories. Previous studies that compared FISH and IHC considered FISH the gold standard, although there are emerging data on ALK fusion variants that question the role of FISH.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Here, we report our personal experience with the use of the IHC, FISH and next-generation sequencing (NGS) analyses in a group of ALK rearranged NSCLC patients treated within our institution

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 13 patients with NSCLC was positive for ALK rearrangements on IHC and was subsequently tested with FISH. Interestingly 5 out of 13 patients were negative on FISH but all the patients received first line ALK inhibitors. The response rate (RR) was 79% (10/13), the progression free survival (PFS) was 19 months for the total population. Among the non-responders 2/13 were FISH negative but 1/13 was IHC and FISH positive. We are going to retrospectively perform NGS analyses to further assess the role of NGS fusion in the context of ALK patients.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our study suggests that IHC is a valid, quick and reliable assay for the detection of ALK gene rearrangements. It also shows that FISH should not be considered the gold standard on its own for the detection of ALK gene rearrangements. We are going to present the data on NGS fusion in this group of patients at the next conference (WLLC November 2018) with the view of seeing if NGS fusion could and should be a valid alternative and replace FISH as the gold standard.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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