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Chengshui Chen
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P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.01-65 - Assessment of Individual and Combined of Five Serum Tumor Markers for Lung Cancer (ID 13899)
16:45 - 18:00 | Author(s): Chengshui Chen
- Abstract
Background
Tumor markers were often used to help in diagnosis lung cancer, The best known tumor markers in lung cancer were SCC, CEA,CYFRA21-1,NSE,and ProGRP. The roles of these tumor markers in diagnosis remain to be determined.
a9ded1e5ce5d75814730bb4caaf49419 Method
This retrospective study conducted between January 2015 and April 2017 at the First Affiliated Hospital of Wenzhou Medical University in China. A total of 2569 patients sought medical attention for a pulmonary mass presence to either confirm or exclude the disease.SCC,CEA,Cyfra21-1,NSE and ProGRP were examied with suspicious lung cancer. SPSS 20.0 used for all statistical analyses.
4c3880bb027f159e801041b1021e88e8 Result
Finally,1135 patients were excluded,1434 patients were selected.Lung cancer was established in 1095 patients(737 males and 358 females), average age of（65.3±10.8）years and excluded in 339 patients (229 males, 117 females),average age of (55.7±13.4).Abnormal CEA were represented in 65.6% of adenocarcinoma. SCC-Ag and CYFRA21-1 significantly higher in 59.8% and 79.0% of squamous cell carcinoma respectively. Abnormal values of NSE and ProGRP were associated with 93.3% and 80.2% of SCLC.CEA and CYFRA 21-1 recorded sensitivity of 65.6% and 65.3% respectively in adenocarcinoma. In squamous cell carcinoma, SCC-Ag and CYFRA21-1 displayed sensitivity of 59.8% and 79% respectively. In SCLC, NSE and ProGRP showed sensitivities of 93.5% and 80.8%.The combination of different tumor markers yielded sensitivity values (>90%) and specificity values (>57%). The combination of five tumor markers recorded the highest sensitivity of 95.6%. The CYFRA 21-1 combine with CEA recorded the highest specificity 79.9%. ROC curves were plotted to explore the diagnostic role of these tumor markers individually and in combination. CYFRA 21-1 with AUC of 0.84〔95%CI 0.820-0.863〕performed better than CEA and the other remaining individual tumor markers. The combination of five tumor markers, with an AUC of 0.904〔95%CI 0.888-0.920〕 is the highest. showed as figure 1.
8eea62084ca7e541d918e823422bd82e Conclusion
Combined TMs can potentially improve the specificity and sensitivity values in LC diagnosis
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P2.01-66 - Comparison of EGFR Mutation Status in Tissue and Plasma Cell-Free DNA Detected by ARMS in Advanced Lung Adenocarcinoma Patients (ID 12532)
16:45 - 18:00 | Author(s): Chengshui Chen
- Abstract
Background
EGFR mutation is a reliable and sensitive biomarker for the treatment of advanced lung adenocarcinoma patients using EGFR-TKIs. Tumor tissue has been used as the standard sample for EGFR mutation detection in the clinical practice currently, but it has some limitations. Therefore, EGFR mutation detection in plasma cell-free DNA has been applied to the clinical practice, however, its diagnostic accuracy remains not consistent.
a9ded1e5ce5d75814730bb4caaf49419 Method
The present prospective study enrolled adult patients presenting with advanced lung adenocarcinoma. EGFR mutations detection in plasma cfDNA and tumor tissues by ADx-ARMS were tested. NGS in plasma was performed in patients with inconsistent gene regions mutation in the paired plasma and tissue samples by ADx-ARMS. We calculated the clinical sensitivity, specificity, positive prediction value (PPV), and negative prediction value (NPV) of ADx-ARMS for EGFR mutation status in plasma cfDNA, considering the mutations in tumor tissues as gold standard for measurements. The objective response rate (ORR) and progression-free survival (PFS) were also calculated in patients with EGFR mutation and receiving first-generation EGFR-TKIs therapy.The study protocol was approved by the Institutional Review Board of the first affiliated hospital of Wenzhou Medical University(2016-017).
4c3880bb027f159e801041b1021e88e8 Result
203 patients were enrolled, mutations were discovered in 58.6% (119/203) of tumor tissues and same mutations in 31.0% (63/203) of the matched plasma using ADx-ARMS. The overall rate of consistency of the EGFR mutation statuses for the paired plasma and tissue samples was 71.9%. The sensitivity and the specificity of detecting EGFR mutations in the plasma by ADx-ARMS were 52.9% and 98.8%, respectively.There were 3 cases inconsistent tissue with plasma in gene regions: 1 carried both 19-Del +T790M in tumor tissue but carried single 19-Del in plasma, and 2 carried both L858R +T790M but single L858R in plasma. We validated by NGS. An objective response rate (ORR) of 58.3% was observed among the 72 patients who were mutation-positive in tumor tissues and received Gefitinib or Icotinib as first-line treatment. And the ORR was 61.9% among the 42 patients with EGFR mutations in plasma. The median PFS of patients with EGFR mutations detected by ADx-ARMS in tumor tissue and plasma were 9.50 months versus 10.25 months. The median PFS of patients with EGFThe median PFS of patients with EGFR wild-type in plasma was 8.50 months There were no significant differences among them (P=0.277).
8eea62084ca7e541d918e823422bd82e Conclusion
ADx-ARMS is an approach with high specificity but moderate sensitivity to detect the EGFR mutations in plasma cfDNA for patients with advanced lung adenocarcinoma.
6f8b794f3246b0c1e1780bb4d4d5dc53
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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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P3.01-58 - Relative Abundance Of EGFR Mutations in Plasma Predicts Tumor Response to EGFR-TKI in Advanced Lung Adenocacarcinoma (ID 12529)
12:00 - 13:30 | Author(s): Chengshui Chen
- Abstract
Background
It is unclear whether relative abundance of EGFR mutations in plasma predicts tumor response treatment with EGFR–TKIs in advanced lung adenocarcinoma.
a9ded1e5ce5d75814730bb4caaf49419 Method
The present prospective study enrolled patients with advanced lung adenocarcinoma in the first affiliated hospital of Wenzhou Medical University from 1 April 2016 to 1 January 2017. EGFR mutations detection in tumor tissues by ADx-ARMS and in plasma cfDNA by ADx-ARMS and ADx-SuperARMS were all tested. We enrolled patients with EGFR-mutant in tumor tissue and receiving EGFR-TKIs. Mutation-positive plasma by both methods carried high abundance of EGFR mutations. Plasma that was mutation positive by ADx-SuperARMS but the result by ADx-ARMS was negative harbored medium abundance. Mutation-negative plasma by both methods was recognized as low abundance group. The correlation between EGFR mutation abundance and clinical benefit from EGFR-TKIs treatment was analyzed using Kaplan-Meier curve, Chi-square test and Cox proportional hazards model.The study protocol was approved by the Institutional Review Board of the first affiliated hospital of Wenzhou Medical University(2016-017).
4c3880bb027f159e801041b1021e88e8 Result
71 patients were enrolled, 42 harbored EGFR mutations in plasma detected by ADx-ARMS, while 53 were found positive result in plasma by ADx-SuperARMS. Median PFS was 10.0m and ORR was 64.8% in the patients with EGFR-mutant in tumor tissue. According to the results of the plasma detected by ADx-ARMS and ADx-SuperARMS, 42 were found high abundances of EGFR mutations, 11 were recognized as medium abundances group while the other 18 as low abundances. The ORRs were 69.0%，63.6% and 55.6% for patients with high、medium and low abundance of EGFR mutations, respectively. Pwith high abundances of EGFR mutations were seemed to acquire high ORRs, the difference was significant between high and low abundances group(P=0.006) but the differences were not significant when compared high abundances group with medium abundances group (P=0.732) and medium abundances group with low abundances group (P=0.114). Medium PFS for high,medium and low abundances groups were 11.0m, 8.5m and 9.0m, respectively(P<0.001). For the patients with 19-Del in tumor tissues, the ORRs were 70.4%，57.1% and 54.5% in high、medium and low abundance of EGFR mutations groups, respectively. Medium PFS of high abundance group was longer than medium and low abundance groups (12.0m vs 9.0m vs 9.0m). As for L858R, the ORRs were 66.7%，50.0% and 50.0%，respectively, Medium PFS were 9.6m, 5.5m and 9.5m.
8eea62084ca7e541d918e823422bd82e Conclusion
The relative EGFR mutation abundance in plasma could predict tumor response to EGFR-TKI treatment for advanced adenocarcinoma. The higher the EGFR mutation abundance is, the better efficacy of EGFR-TKI is.
6f8b794f3246b0c1e1780bb4d4d5dc53
