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Xia Song



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    JCSE01 - Perspectives for Lung Cancer Early Detection (ID 779)

    • Event: WCLC 2018
    • Type: Joint IASLC/CSCO/CAALC Session
    • Track: Screening and Early Detection
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/23/2018, 07:30 - 11:15, Room 202 BD
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      JCSE01.18 - A Multicenter Survey of One Year Survival Among Chinese Patients with Advanced Nonsquamous Non-Small Cell Lung Cancer (CTONG1506) (ID 14707)

      11:15 - 11:15  |  Author(s): Xia Song

      • Abstract
      • Slides

      Background
      Previous results of CTONG1506 study showed that gene aberration test rate was increasing in Chinese NSCLC patients and first-line treatment was standardized accordingly. This survey further described one year survival of patients with different gene aberration status and under different first-line treatments.

      CTONG1506 was a two-year series cross-sectional study. Patients with advanced nonsquamous NSCLC who were admitted from August 2015 to March 2016 and who received first-line anti-cancer treatment at one of 12 tertiary hospitals across China were included. Data extracted from medical charts were entered into medical record abstraction forms, which were collated for analysis. Survival information was collected one year after patients were admitted to hospital. One year survival rate and its 95% confidence interval were analysed by Kaplan-Meier method.

      A total of 707 patients were analysed, with mean age of 57 years and 56.7% were male. Among the 487 patients who had survival data, 192 were EGFR- mutation positive (86 mutated in exon 19 [one year survival rate 0.90, 95% CI: 0.81-0.94] and 88 mutated in exon 21 [one year survival rate 0.84, 95% CI: 0.75-0.90]), 27 patients were ALK positive and 164 patients were EGFR and ALK wild type. Most EGFRmutation positive patients (128/192) received tyrosine kinase inhibitors (TKIs) as first-line treatment and most EGFR wild type patients (155/175) received first-line chemotherapy (Chemo). Pemetrexed was the most common non-platinum chemotherapy-backbone agent (120/155) in platinum doublet regimens. One year survival rates are shown in the table.

      abstract 12337 ctogn1506 one-year survival.png

      This national-wide real world study of tertiary hospitals in China revealed that a majority of (>75%) advanced nonsquamous NSCLC patients survived more than one year and was comparable to well-controlled clinical trial results, indicating survival benefits by gene aberration status guided standard of care. This result may be further validated by our on-going two-year survey.

      a9ded1e5ce5d75814730bb4caaf49419

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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
    • Now Available
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.01-130 - Detection of Actionable Mutation Status in Advanced Non-Small Cell Lung Cancer by Next-Generation Sequencing of Circulating Tumor DNA (Now Available) (ID 13164)

      16:45 - 18:00  |  Presenting Author(s): Xia Song

      • Abstract
      • Slides

      Background

      Genotype directed therapy has become increasingly important for personalized therapy of patients with advanced non-small cell lung cancer(NSCLC),but obtaining tumor tissue for genetyping remains a challenge.Plasma circulating tumor DNA(ctDNA) analysis by next-generation sequencing (NGS)may allow for noninvasive evaluation.We demonstrate the feasibility and clinical utility of ctDNA NGS in the management of advanced NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 114 plasma samples were detected by NGS to identify actionable oncogenic driver mutations or mechanisms of resistance in 108 patients with advanced NSCLC.Among those 108 patients,there were 79 paired tissue DNA (tDNA) detected using ARMS PCR,We also evaluated the concordance in detecting of EGFR between ctDNA and paired tDNA.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 114 plasma ctDNA , 47(47/114,41%) actionable somatic mutations and 1 EGFR T790M germline mutation were dectected.EGFR variants were most common(39/114,34%).Among the 79 patients with matched tDNA and ctDNA, 32(32/79,41%)therapeutically targetable EGFR mutations were detected in tDNA and 30(30/79,38%) in ctDNA samples, yielding an overall concordance of 70%,the sensitivity and specificity of NGS were 59% and 77%.Of the 47patients with tDNA negative,11(11/47,23%)patients harbored EGFR mutation detected in ctDNA during the course of their disease.Of the 31 patients with brain metastases,22(71%)harbored an EGFR sensitive mutation(15,48%EGFR 19del and 7,23%EGFR L858R).Of the 40 patients who resistant to 1st and 2nd EGFR-TKI therapy,14(14/40,35%) showed the T790M acquired resistance mutation.the mean time of EGFR-TKI resistance was 11.5months.Patients with T790M mutations had significantly better PFS than those without T790M.

      8eea62084ca7e541d918e823422bd82e Conclusion

      CtDNA NGS can be adopted as a tool for providing precision genomic analysis and dynamic monitoring, thus improving patient management, and even,undertaking hereditary counseling.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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      P2.01-93 - The Analysis of the Soluble Programmed Death-1 of Lung Cancer Patients with Different Characteristics (Now Available) (ID 13760)

      16:45 - 18:00  |  Presenting Author(s): Xia Song

      • Abstract
      • Slides

      Background

      Programmed death 1 ligand-1(PD-L1) is important regulators in cancer immunity. The aim of this study was to evaluate the values of the expression of the soluble programmed death-1(sPD-L1) in the plasma of patients with lung cancer, and to investigate the associations between the expression level of sPD-L1 and clinicopathological features as well as effective and survival outcomes.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A total of 200 patients with non-small cell lung cancer(NSCLC)(n=188) and small cell lung cancer(SCLC)(n=12) treatment naive were explored, 96 samples of healthy subjects and 13 samples of benign tumours were studied as control. The sPD-L1 expression was scored by the way of anenzyme-linked immunosorbent assay (ELISA). We followed up 67 patients with NSCLC before and after standard treatment, and blood samples were taken every two months. We compared sPD-L1 expression with clinicopathological features and patients outcomes.

      4c3880bb027f159e801041b1021e88e8 Result

      The Expression of sPD-L1 in patients of lung cancer was significantly higher than benign tumour group and healthy group (3.01±3.00ng/ml, 1.76±1.74ng/ml, 1.82±1.20ng/ml, P=0.002). The level of sPD-L1 in lung cancer was not associated with gender, age, smoking history, and histologic subtypes(P>0.05). The level of sPD-L1 was significantly higher in patients of worse PS(performance status)(PS≥2) than better PS(PS<2) (6.40±6.53 vs. 2.68±2.06 P=0.005). The level of sPD-L1 with later stages were remarkable higher than earlier stages(P<0.001) in NSCLC patients. The expression of sPD-L1 of the patients with epidermal growth factor(EGFR) mutated adenocarcinoma was higher than EGFR-wild group(4.30±1.82ng/ml vs. 3.76±1.57ng/ml, P=0.271). The decline of the level of sPD-L1 was correlated with the effects of good response and progressive disease(PD)(0.49±1.48ng/ml vs. 0.11±0.52ng/ml, P=0.307). As for survival, there was no difference between the decline of level of sPD-L1 and the progress free survival(PFS).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our results indicated that the elevated expression of sPD-L1 of patients with NSCLC was associated with later stages and worse life conditions, and which may correlated with bad clinical response and poor prognosis. EGFR mutation status may affect the expression of sPD-L1. Further studies are needed to determine the role of sPD-L1 as a molecular prognosis marker for the treatment and prognosis of patients with lung cancer.

      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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      P3.01-113 - A Multicenter Survey of One Year Survival Among Chinese Patients with Advanced Nonsquamous Non-Small Cell Lung Cancer (CTONG1506) (ID 12337)

      12:00 - 13:30  |  Author(s): Xia Song

      • Abstract

      Background

      Previous results of CTONG1506 study showed that gene aberration test rate was increasing in Chinese NSCLC patients and first-line treatment was standardized accordingly. This survey further described one year survival of patients with different gene aberration status and under different first-line treatments.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      CTONG1506 was a two-year series cross-sectional study. Patients with advanced nonsquamous NSCLC who were admitted from August 2015 to March 2016 and who received first-line anti-cancer treatment at one of 12 tertiary hospitals across China were included. Data extracted from medical charts were entered into medical record abstraction forms, which were collated for analysis. Survival information was collected one year after patients were admitted to hospital. One year survival rate and its 95% confidence interval were analysed by Kaplan-Meier method.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 707 patients were analysed, with mean age of 57 years and 56.7% were male. Among the 487 patients who had survival data, 192 were EGFR- mutation positive (86 mutated in exon 19 [one year survival rate 0.90, 95% CI: 0.81-0.94] and 88 mutated in exon 21 [one year survival rate 0.84, 95% CI: 0.75-0.90]), 27 patients were ALK positive and 164 patients were EGFR and ALK wild type. Most EGFR mutation positive patients (128/192) received tyrosine kinase inhibitors (TKIs) as first-line treatment and most EGFR wild type patients (155/175) received first-line chemotherapy (Chemo). Pemetrexed was the most common non-platinum chemotherapy-backbone agent (120/155) in platinum doublet regimens. One year survival rates are shown in the table.

      abstract 12337 ctogn1506 one-year survival.png

      8eea62084ca7e541d918e823422bd82e Conclusion

      This national-wide real world study of tertiary hospitals in China revealed that a majority of (>75%) advanced nonsquamous NSCLC patients survived more than one year and was comparable to well-controlled clinical trial results, indicating survival benefits by gene aberration status guided standard of care. This result may be further validated by our on-going two-year survey.

      6f8b794f3246b0c1e1780bb4d4d5dc53