Author of

• 25938

  +

  P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 26894

    +

    P2.01-90 - PD-L1 Expression as a Predictive Biomarker in Advanced Non-Small Cell Lung Cancer Patients with or without EGFR Mutation (ID 13528)

    16:45 - 18:00  |  Author(s): Kaettipong Kamprerasart
    • Abstract
    • Slides

    Background
    

    The prognostic value of PD-L1 expression and its clinical relevance of NSCLC is controversy. The impact of PD-L1 expression as the predictive biomarker for EGFR-TKIs treatment is needed to explore.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Medical records of metastatic NSCLC during September 2015-2016 had been reviewed. PD-L1 immunohistochemistry (IHC) staining with Antibody clone 22C3 was used. The PD-L1 positive was defined by tumor proportion score (TPS) > 1%.

    4c3880bb027f159e801041b1021e88e8 Result
    

    204 patients were included. Patients with positive PD-L1 expression had significantly increased numbers of metastatic sites (P=0.009) and lung metastasis (P=0.045) compared to PD-L1 negative patients. Overall survival (OS) was longer in PD-L1 negative patients (22.7 months) compared to PD-L1 positive groups (13.6 months) (HR=1.48; P=0.03). Median OS were significantly different with the number of 7.2, 11.1, 25.7, 42.6 months in EGFR-/PD-L1+, EGFR-/PD-L1-, EGFR+/PD-L1+ and EGFR+/PD-L1- , respectively (P<0.001). Among EGFR positive patients, mOS of T790M-/PD-L1+, T790M-/PD-L1-, T790M+/PD-L1-, and T790M+/PD-L1+ were 22.1, 28, 42.6 and 48.4 months, respectively (P=0.03).

    Patient characteristics categorized by PD-L1 expression (N = 204)

    Characteristics	PD-L1 Negative N=134 (65.69%)	PD-L1 Positive N=70 (34.31%)	P value
    Age - Median age (range) - < 65 years - > 65 years	65 (36-85) 64 (47.76) 70 (52.24)	65 (35-86) 33 (47.14 37 (52.86)	0.933
    Sex - Male - Female	62 (46.27) 72 )53.73)	37 (52.86) 33 (47.14)	0.371
    ECOG PS - 0-1 - > 2	116 (86.57) 18 (13.43)	57 (82.61 12 (17.39)	0.452
    Smoking status - Never - Ex-smoker - Current smoker	82 (61.65) 36 (27.07) 15 (11.28)	36 (52.17) 18 (26.09) 15 (21.74)	0.131
    Mean smoking pack-year (range)	29.72 (2-100)	25.68 (2-40)	0.873
    Initial staging - Recurrent - Denovo metastasis	32 (23.88) 102 (76.12)	14 (20) 56 (80)	0.529
    Histology - Adenocarcinoma - Squamous cell carcinoma - Adenosquamous carcinoma - Others	117 (87.31) 1 (0.75) 2 (1.49) 14 (10.45)	58 (84.06) 3 (4.35) 2 (2.9) 6 (8.7)	0.288
    EGFR mutation - Negative - Positive	47 (35.07) 87 (64.93)	32 (45.71) 38 (54.29)	0.092
    Exon 19 deletion - No - Yes	87 (64.93) 47 (35.07)	50 (71.43) 20 (28.57)	0.348
    L858R - No - Yes	100 (74.63) 34 (25.37)	53 (75.71) 17 (24.29)	0.865
    ALK results - Negative - Positive	79 (92.94) 6 (7.06)	47 (97.92) 1 (2.08)	0.421
    Number of site of metastasis - 0-1 - > 2	88 (65.67) 46 (34.33)	37 (52.86) 33 (47.14)	0.009
    Lung metastasis - No - Yes	92 (69.17) 41 (30.83)	38 (54.29) 32 (45.71)	0.045
    Bone metastasis - No - Yes	101 (75.37) 33 (24.63)	53 (75.71) 17 (24.29)	0.957
    Liver metastasis - No - Yes	122 (91.04) 12 (8.96)	62 (88.57) 8 (11.43)	0.573
    Pleural metastasis - No - Yes	91 (67.91) 43 (32.09)	62 (88.57) 20 (28.57)	0.606
    Brain metastasis - No - Yes	117 (87.31) 17 (12.69)	58 (82.86) 12 (17.14)	0.387
    Adrenal metastasis - No - Yes	122 (91.04) 12 (8.96)	62 (88.57) 8 (11.43)	0.573

    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    PD-L1 expression was associated with poorer survival outcomes among advanced NSCLC patients regardless of EGFR mutation status. PD-L1 expression is also the potential of predictive biomarker for EGFR TKIs treatment. The larger studies are needed to identify the prognostic and predictive values in T790M mutation population.

    6f8b794f3246b0c1e1780bb4d4d5dc53

    Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

• 25963

  +

  P3.09 - Pathology (Not CME Accredited Session) (ID 975)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27584

    +

    P3.09-08 - Tumor Heterogeneity and Molecular Profile of NSCLC in Thai Population (ID 14016)

    12:00 - 13:30  |  Author(s): Kaettipong Kamprerasart
    • Abstract
    • Slides

    Background
    

    Oncogenic driven mutation is the key to develop targeted therapy in lung cancer. Different ethnicity and tumor heterogeneity affect the prevalence of molecular alteration. This study aimed to explore the unique molecular profile of lung adenocarcinoma in Thai population.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We studied 166 lung adenocarcinoma patients’ molecular profile using Next Generation Sequencing (NGS) on 45 genes lung cancer panel (Ion Torrent system). Variants from NGS with coverage of higher than 1000X and cut off at 2% alternate variant frequency were considered positive. We validated the positive mutation of EGFR, BRAF, and KRAS by Real- Time PCR using the Amoy DX kit.

    4c3880bb027f159e801041b1021e88e8 Result
    

    This study found 68%(113/166) of EGFR mutation, 9.6%(16/166) of BRAF V600E, 32.5% (54/166) of KRAS mutation, 9%(15/166) of MET exon14 splice site, 4.8% (8/166) AKT mutation (E17K), 2.4% (4/166) of ROS1 mutation, 0.6% (1/166) of PIK3CA mutation (H1047R), and 0.6% (1/166) of PTEN mutation. Furthermore, we also found 40 patients (24.1%) who had more than one mutation in each person. We further validated the positive results by Real-Time PCR. Thirteen patients were obtained tissue from different organs and some with different period of time. T790M usually develop later in EGFR-positive patients who failed 1^st or 2^nd generation EGFR-TKI. Two patients (patient 5&9) who had lung surgery different lobe in same operation, had different mutation in tissues and one patient (patient 13) who obtained tissue from lung and pleural effusion cell block in different period of time had totally different mutation (Table1).

    Table1 Tumor heterogeneity profile in lung cancer patients

    case	Hetrogenety in different organ	date obtained tissue	Gene mutation
    			EGFR	KRAS	ROS	PTEN	AKT	MET	BRAF
    1	RLL lobectomy	12-Jun-2012	Exon 19 Deletion	negative	negative	negative	negative	negative	negative
    	Right lung	4-May-2016	Exon 19 Deletion T790M	negative	negative	negative	negative	negative	negative
    2	lymph node	16-Mar-2017	negative	negative	negative	negative	negative	negative	negative
    	Bone	9-Apr-2017	negative	negative	negative	negative	negative	negative	negative
    3	Right upper lung biopsy	20-Jan-2016	Exon 19 Deletion	negative	negative	negative	negative	negative	negative
    	Lung biopsy	31-Mar-2017	T790M	negative	negative	negative	E17K	negative	negative
    4	lymph node	13-Jan-2016	negative	G12A	negative	negative	negative	negative	negative
    	skin	17-Jan-2016	negative	G12V G12D	negative	negative	negative	negative	negative
    	left humerous	30-Jun-2016	negative	G12V	negative	negative	negative	negative	negative
    5	RML lobectomy	13-Nov-2013	Exon 19 Deletion	G13D	negative	negative	negative	negative	negative
    	LUL lobectomy	14-May-2014	negative	G12D G13D	negative	R233*	negative	negative	negative
    	LUL lobectomy	14-May-2014	negative	G12V G12D	D2033N	negative	negative	negative	negative
    6	Right pleura biopsy	11-Jan-2016	Exon 19 Deletion	negative	negative	negative	negative	negative	negative
    	RUL biopsy	1-Mar-2017	Exon 19 Deletion	negative	negative	negative	negative	negative	negative
    7	RUL biopsy	28-Sep-2015	L858R	negative	negative	negative	negative	negative	negative
    	Left pleural fluid cell block	27-Jun-2016	negative	negative	negative	negative	negative	negative	negative
    8	Right pleural fluid cell block	25-Mar-2016	Exon 19 Deletion	negative	negative	negative	negative	negative	negative
    	Left pleural fluid cell block	9-Dec-2016	T790M	negative	negative	negative	negative	negative	negative
    9	RML lobectomy	14-Mar-2013	negative	G13S	negative	negative	E17K	negative	negative
    	RLL wedge resectionRLL lo	30-Mar-2017	G719A L861Q	negative	negative	negative	negative	negative	negative
    10	RLL lobectomy	26-Aug-2013	negative	G12C G12D	negative	negative	negative	negative	negative
    	Left lingular lobe segmental resection	9-Oct-2014	negative	G12D	negative	negative	negative	negative	negative
    	LUL wedge resection	11-Feb-2016	negative	G12D	negative	negative	negative	negative	negative
    	LUL lobectomy	4-Jun-2017	negative	G12D	negative	negative	negative	negative	negative
    	LLL resection	9-Oct-2014	negative	G12D	negative	negative	negative	negative	negative
    11	Right pleural cell block	21-Jul-2014	L858R	negative	negative	negative	negative	c.3028G>A exon 14 splicing	negative
    	Ascites	9-Jun-2017	T790M L858R	negative	negative	negative	negative	negative	negative
    12	LUL biopsy	24-Feb-2015	L858R	negative	negative	negative	negative	negative	V600E
    	Lt lung biopsy	8-Jul-2016	L858R	negative	negative	negative	negative	negative	negative
    13	RLL biopsy	14-Oct-2015	negative	negative	negative	negative	negative	c.3028+1G>T exon 14 splicing	negative
    	pleural fluid cell block	15-Nov-2016	Exon 19 Deletion T790M	negative	negative	negative	negative	negative	negative

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Thai populations have unique molecular alteration compared to the other ethnicities, especially, higher of BRAF V600E and MET exon14 splice site. Our population also has high co-mutation prevalence. Tumor heterogeneity is needed to explore in the larger cohort.

    6f8b794f3246b0c1e1780bb4d4d5dc53

    Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.