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Hajime Saito
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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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P1.09-28 - Clinical Utility of Rapid Immunohistochemistry for Differentiation of Solitary Pulmonary Adenocarcinomas (ID 12333)
16:45 - 18:00 | Author(s): Hajime Saito
- Abstract
Background
Intraoperative differentiation between pulmonary metastasis and primary lung cancer is necessary for determining the appropriate range of excision. Although conventional immunohistochemistry is often used for such differentiation, its intraoperative use is limited by time constraints. We therefore developed a device that enables complete and rapid immunohistochemistry (R-IHC) within 20 minutes, and used it with anti-thyroid transcription factor-1 (TTF-1) for differential diagnosis of pulmonary adenocarcinoma. However, the diagnostic accuracy of the method likely can be improved by using a combination of two or more antibodies. We therefore evaluated the clinical utility of R-IHC with combinations of antibodies for discriminating the etiology of solitary pulmonary adenocarcinomas.
a9ded1e5ce5d75814730bb4caaf49419 Method
Twenty-two patients with pulmonary adenocarcinomas treated between February 2015 and May 2017 were enrolled in this prospective study. Tumor samples were sectioned, labeled with multiple antibodies using R-IHC, and pathologically evaluated. The standard used for comparison was conventional hematoxylin eosin (HE) staining and IHC.
4c3880bb027f159e801041b1021e88e8 Result
All intraoperative diagnoses made using R-IHC were consistent with the final diagnosis; that is, the accuracy was 100%. Moreover, the respective staining with each antibody corresponded between intraoperative R-IHC and IHC with the permanent specimen. For rapid intraoperative diagnosis differentiating pulmonary adenocarcinoma from lung metastasis from colon cancer, R-IHC with a combination of TTF-1, cytokeratin (CK) 7, and CK20 antibodies was highly effective.
8eea62084ca7e541d918e823422bd82e Conclusion
Our novel R-IHC method with multiple antibodies was highly effective for diagnosis and differentiation of solitary pulmonary adenocarcinomas. This technology may prove to be an important supplement to standard intraoperative pathologic diagnosis in routine practice.
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P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)
- 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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P3.01-42 - Phase II Trial Allowed Surgery After Induction Chemotherapy of CBDCA+PTX, Bevacizumab in Patients with Stages IIIA-IV Nonsquamous NSCLC (ID 11137)
12:00 - 13:30 | Author(s): Hajime Saito
- Abstract
Background
Surgery remains the best therapy for cure in non-small cell lung cancer (NSCLC). However, the treatment strategy for advanced NSCLC patient including Stage III with N2 remains controversial. Bevacizumab (Bv), a humanized monoclonal antibody targeting VEGF, combined with the standard platinum doublet-based chemotherapy is approved for the first-line treatment of NSCLC. This study aimed to determine whether the treatment allowed surgery after induction chemotherapy of carboplatin (CBDCA) and paclitaxel (PTX) with Bv provides a reduction in the risk of progression in patients with stages IIIA to IV non-squamous NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Method
This clinical trial was an open-label, multicenter, single-arm study involving 10 institutions in Akita, Japan (UMIN000007916). Chemotherapy/radiation-naive patients > 20 years of age, ECOG performance status of 0 to 1, and adequate hematologic, hepatic, and renal function with cytologically or histologically confirmed stages IIIA to IV nonsquamous NSCLC not amenable to surgical resection or radiation with curative intent, were eligible. Treatment plan is showed in Figure 1.
4c3880bb027f159e801041b1021e88e8 Result
Between April 2012 and October 2017, a total 29 patients were enrolled. The overall response rate was 72.4%, 10 of 29 patients underwent radical surgery included lymph node dissection 2a-2 basically after the chemotherapy. Complete resection was achieved in 7 patients of them (70%) in the induction chemotherapy group. Bronchial stump and anastomoses were buttressed with a pericardial flap or intercostal muscle flap in some cases. The 30-day hospital mortality was 0% in the all patients who underwent operation. Grade 3 or 4 adverse events occurred in 72.4% such as neutropenia, just one case has pulmonary hemorrhage and GI bleeding.
8eea62084ca7e541d918e823422bd82e Conclusion
These results suggest that CBDCA+PTX, Bv which has higher response rate will introduce the better potential to reduce tumor size, increase operability, and eradicate micro-metastases. However, a survival benefit might be limited even though surgery was added after induction chemotherapy.
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