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Yinghui Xu
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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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P1.09-14 - Analysis of Real-Word Mutations of Lung Cancer Driver Genes in 3081 Patients from China (ID 13649)
16:45 - 18:00 | Author(s): Yinghui Xu
- Abstract
Background
Patients with different races and regions have different mutation characteristics in driver genes. This study included 3081 lung cancer patients that were detected for three major driver genes from five regions of China.
a9ded1e5ce5d75814730bb4caaf49419 Method
EGFR, EML4-ALK and ROS1 gene mutations were detected by fluorescence quantitative PCR (all use the same kit from AmoyDx). Chi-square test and logistic regressive analysis were used to analyze the clinicopathological features.
4c3880bb027f159e801041b1021e88e8 Result
From January 1 to December 31, 2017, a total of 1,449 driver genes were detected mutations (47.03%). The EGFR gene mutation rate was 40.1% (1259/3081), the EML4-ALK was 5.5% (169/3081), and the ROS1 was 1.3% (39/3081). EGFR and EML4-ALK coexistence in 17 cases (0.5%), 1 case of EGFR and ROS1 coexistence (0.03%). The EGFR gene mutation sites were mainly 19Del (557/3081) and 21 exon L858R (575/3081). The proportions of EGFR mutation sites are shown in the figure. EGFR gene mutation was negatively correlated with EML4-ALK and ROS1. Patients with EGFR, EML4-ALK, and ROS1 mutations have different population characteristics, which were listed in the table.
8eea62084ca7e541d918e823422bd82e Conclusion
The real-word driver gene mutations in large population of China are far higher than in the US and Europe, slightly less than in other reports of specially screened Asian populations.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P2.09 - Pathology (Not CME Accredited Session) (ID 958)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.09-16 - Heterogeneity Analyses of MSLCs——Especially in the EGFR Mutation-Positive Ones (ID 12914)
16:45 - 18:00 | Presenting Author(s): Yinghui Xu
- Abstract
Background
Multiple synchronous lung cancers (MSLCs) are diagnosed as multiple tumor nodules in the same or different lung lobes. MSLCs present a clinical dilemma whether they are primary tumors or metastases. Recent studies showed that MSLCs shared an identical germline genetic background and environmental exposure in the same individual patient, however, different tumor nodules showed highly different heterogeneity, even in all the EGFR mutation-positive focuses. Therefore, we performed this study to further analyze MSLCs as to estimate the pathology and molecule heterogeneity among these nodules.
a9ded1e5ce5d75814730bb4caaf49419 Method
Tumor samples were obtained from nine patients diagnosed with MSLCs. Immunohistochemistry were performed by professional pathologists. Whole-exome sequencing (WES) was conducted by IlluminaNovaseq with sequencing depth of 200X. NeoTyping was used to describe the dispersion of sequencing data among MSLCs of the same patient.
4c3880bb027f159e801041b1021e88e8 Result
We found different tumor nodules showed obviously pathological and molecular heterogeneities in the same individual (Figure 1). More different dispersion was observed among the nodules with more different pathologies in the same patient. The dispersion of 20%, 50% and 100% were observed in MSLCs with the same driver genes (such as EGFR exon21 L858R and L861Q) of lung adenocarcinoma, different evolutional stages (AAH, MIA and IA) and completely different pathologies (adenocarcinoma and squamous cancer), respectively. All the sequencing data showed MSLCs had different gene information, even in all the EGFR mutation-positive nodules, maybe similar, but not the same, which supported that each nodule in one patient was independent with others.
8eea62084ca7e541d918e823422bd82e Conclusion
MSLCs could be independent with each other due to their pathological and molecular heterogeneities, even for EGFR mutation-positive nodules which hold the same driver gene, but different mutation site in just one patient. WES should be an effective way to recognize this heterogeneous characteristic, which would be helpful for the whole precise management of one MSLC patient.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.08 - Oligometastatic NSCLC (Not CME Accredited Session) (ID 974)
- 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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P3.08-15 - Lung Squamous Cell Carcinoma with Solitary Ocular Metastasis，Successful Treatment: An Interesting and Rare Case Report (ID 13697)
12:00 - 13:30 | Author(s): Yinghui Xu
- Abstract
Background
The incidence of ocular metastases from lung cancer is reported to be 0.1%-7% according to the international literature. Adenocarcinoma and small-cell lung cancer occupied the most proportion. Lung squamous cell carcinoma with solitary symptomatic ocular metastasis as the initial manifestation who accepted the multidisciplinary team （MDT）treatment has never been reported.
a9ded1e5ce5d75814730bb4caaf49419 Method
In the diagnosis of intracranial disease, ophthalmofundoscopy can be used for follow-up observation and evaluation of therapeutic effects. Whole body PET -CT imaging can be used to identify the primary cancer and determine the disease staging.
4c3880bb027f159e801041b1021e88e8 Result
A 62-year-old woman presented to ophthalmology of hospital with a 1-week history of left eye pain, blurred vision. The ophthalmologist performed ophthalmofundoscopy and optical coherence tomography on the patient(Fig.1A). The ophthalmologist initial diagnosis is metastatic carcinoma to the eye. The diagnostic work was completed with PET-CT which confirmed the central lung cancer in the lower lobe of the right lung with ocular metastasis.After multiple disciplinary team consultations, including surgery, internal medicine, ophthalmology, radiotherapy and imaging department, the patient underwent the right lower lobe resection and lymph node dissection in December 2016. Postoperative pathology diagnose the right lung-squamous-cell carcinoma staged T2aN1. In February 2017, the patient reviewed the eye examination and indicated that the ocular lesions were enlarged. The patient received 4 courses of gemcitabine plus cisplatin regimen chemotherapy. The eye symptoms disappeared completely after 4 courses(Fig.2B). The progression-free time was 11.9 months. There're 16.5 months for the patients has been followed up（March,2018） from surgery, and the lesion of ocular was still controlled very well without any specific ocular treatment.
8eea62084ca7e541d918e823422bd82e Conclusion
It's the first report of a rare case with solitary ocular metastasis as the initial manifestation of lung squamous cell carcinoma. The successful treatment of this case was reported to provide a new therapeutic reference for clinicians to encounter similar cases in the future.
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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P3.13-34 - RET Gene, a New Choice for NSCLC (ID 13654)
12:00 - 13:30 | Presenting Author(s): Yinghui Xu
- Abstract
Background
RET gene, accounting for 1-2% of non-small cell lung cancer (NSCLC), has been identified as a novel target molecule which has been reported that could not coexist with other gene mutations such asrejected with the other mutation like KRAS, EGFR, BRAF, MEK1, HER2 and ALK.The emerging targeted agents Cabozantinib and Vandetanib have been recommended by NCCN guidelines for non-small cell lung cancer with RET fusion, based on a series of clinical trials.
a9ded1e5ce5d75814730bb4caaf49419 Method
We presented a case of lung adenocarcinoma with KIF5B/RET fusion. The patient was a 50-year-old, male, non-smoker, diagnosed as left upper lobe adenocarcinoma lung cancer. We performed a radical resection of pulmonary carcinoma for two years ago. Subsequently,he completed four cycles of chemotherapy with gemcitabine and cisplatin. However, half years later, pleural metastasis made him have to receive systemic treatment but no chemotherapy due to his worse tolerance. We then performed a gene examination with the PCR method using the intraoperative specimen, and finally found positive KIF5B/RET fusion gene. From then on June 10,2017, he started to take cabozantinib for treatment.
4c3880bb027f159e801041b1021e88e8 Result
He started to take cabozantinib (140 mg orally, once daily) for about nine months. His disease sustained SD during that period (please see Figure 1). No serious adverse events (AEs) except rash (Ⅱ grade) occurred in the whole treatment process.
8eea62084ca7e541d918e823422bd82e Conclusion
We found that the RET gene is a new alternative for lung adenocarcinoma patients without common mutations such as EGFR, ALK, ROS1 and so on. This case report supports a useful reference for the therapy of lung adenocarcinoma patients with RET mutation and may provide a new choice for this kind of NSCLC patients.
6f8b794f3246b0c1e1780bb4d4d5dc53
