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Jie Xia Zhang
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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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P2.01-107 - Analysis of Mutation Detection by ctDNA on the Basis of Metastatic Sites in Lung Adenocarcinoma Patients (ID 13635)
16:45 - 18:00 | Author(s): Jie Xia Zhang
- Abstract
Background
Circulating tumor DNA (ctDNA) testing represents a powerful tool to detect gene alterations in patients. However, differences in mutation detected by ctDNA related to metastatic sites in lung cancer have not been addressed before and remain to be explored.
a9ded1e5ce5d75814730bb4caaf49419 Method
We reviewed 317 ctDNA samples from 310 lung adenocarcinoma patients with definite metastasis at our institute. Somatic mutation profiles were analyzed using hybridization capture based next-generation sequencing (NGS), which enables the simultaneous detection of single-nucleotide variants, insertions/deletions, rearrangements, and copy-number alterations of 1021 genes.
4c3880bb027f159e801041b1021e88e8 Result
Patients were divided into two groups according to metastatic sites. Any case with metastasis to the bone, liver or adrenal gland falls into the major organ metastasis group, while any case with metastasis to the lung, pleura or lymph node belongs to the local metastasis group. No genetic alteration was detected in 14 (11.5%) of 122 samples in the major organ group and 35 (17.9%) of 195 in the local group. And distant metastasis is associated with more mutations on average detected by ctDNA (5.26 for the major organ group vs 3.72 for the local group; p=0.0039). As for genes involved, the most common mutated ones are EGFR and TP53 for both groups, with an overall mutation rate being 40.6% and 33.2% respectively. And just as average gene alterations mentioned above, the mutation rates of EGFR and TP53 are much higher in the major organ group (49.6% vs 35.2% for EGFR; 43.6% vs 26.9% for TP53). Besides, mutations of NF1, MLL3, KRAS and KEAP1 are more frequent in the major organ group while mutation rate of PIK3CA is slightly higher in the local group (Table).
8eea62084ca7e541d918e823422bd82e ConclusionTable. Some mutated genes detected by ctDNA
major organ metastasis (117)
local metastasis (193)
EGFR
58 (49.6%)
68 (35.2%)
TP53
51 (43.6%)
52 (26.9%)
KRAS
9 (7.7%)
7 (3.6%)
MLL3
9 (7.7%)
6 (3.1%)
NF1
9 (7.7%)
3 (1.6%)
ERBB2
5 (4.3%)
6 (3.1%)
PIK3CA
3 (2.6%)
7 (3.6%)
KEAP1
7 (6.0%)
3 (1.6%)
More gene alterations were detected by sequencing of ctDNA in patients of lung adenocarcinoma with major organ metastasis compared to those with only local metastasis.
6f8b794f3246b0c1e1780bb4d4d5dc53 -
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P2.01-111 - Clinical Features and Prognosis of Eighty-Five Patients with Primary Pulmonary Lymphoepithelioma-Like Carcinoma (ID 12363)
16:45 - 18:00 | Author(s): Jie Xia Zhang
- Abstract
Background
Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of lung cancer that is less reported and not well understood around the world.
a9ded1e5ce5d75814730bb4caaf49419 Method
A retrospective analysis of clinical features for 85 patients was conducted to determine the prognostic factors in terms of age, gender, radiographic features, serum tumor markers, TNM stages, pathological features, treatment and prognosis.
4c3880bb027f159e801041b1021e88e8 Result
PLELC preferentially affects the young (< 60 years old: 71.8%) nonsmokers (72.9%), without significant difference in gender. The median follow-up time was 15 months (1-37 months) for the whole group and most patients were in the early stage with opportunity of operation (50.6%). For the advanced stage group, patients mainly received chemotherapies and radiotherapies, the 0.5-year and 1.5-year PFS rates were 61% and 29%, respectively. The TNM stage (P=0.014) and performance status (PS) (P=0.040) were associated with PFS significantly in the univariate analysis, while TNM stage was an independent prognostic factor in multivariate analysis (P=0.026). In the subtype analysis, patients in the advanced stage receiving Gemcitabine plus platinum (GP group) or Paclitaxel plus platinum (TP group) had better PFS than Pemetrexed plus platinum (PP group) (P=0.005).
8eea62084ca7e541d918e823422bd82e Conclusion
PLELC had a better prognosis compared with other types of non-small cell lung cancer (NSCLC) and was sensitive to radiotherapy and chemotherapy. The current results recommended that the GP and TP should be used as first-line treatment of PLELC. The TNM stage and PS were predictive in prognosis of PLELC patients.
6f8b794f3246b0c1e1780bb4d4d5dc53
