Virtual Library
Start Your Search
Jiexia Zhang
Author of
-
+
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
-
+
P2.01-117 - Concurrent Gene Alterations in Treatment-Naïve EGFR-Mutant Advanced Non-Small Cell Lung Cancer (ID 13102)
16:45 - 18:00 | Author(s): Jiexia Zhang
- Abstract
Background
EGFR-TKIs is the standard first line treatment for EGFR-mutant advanced non-small-cell lung cancer (NSCLC). However, 20% to 30% of patients who receive EGFR-TKIs exhibit primary resistance. The gene alterations in treatment-naïve EGFR-mutant advanced NSCLC should be better explored.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed gene test results of 980 treatment-naïve advanced NSCLC samples in our institute. Tumor biopsy, ctDNA, pleural effusion or cerebrospinal fluid samples were analyzed using hybridization capture-based NGS ER-seq method, white blood cells as control, which enables simultaneously assess single-nucleotide variants (SNV), insertions/deletions (indel), rearrangements and somatic copy-number(CNV) variation at least 59 genes (range 59-1021 genes).
4c3880bb027f159e801041b1021e88e8 Result
Three hundreds and eighty one cases with EGFR sensitive mutation were identified, 358 adenocarcinoma, 7 squamous cell carcinoma, 1 adenosquamous carcinoma and 15 NSCLC. Among the patients, 88 patients (23.1%) harbored concurrent actionable mutations with EGFR, which 43 were exon 19 deletion, 37 were L858R and 8 were uncommon EGFR mutations. One patient had co-occurring L858R, T790M and CDKN2A frameshift mutation. The actionable mutations were from 23 genes, which involved in cellular signaling pathways, and some genes had been reported associated with EGFR-TKIs resistance (details in table). Except the actionable mutations, TP53 mutations were detected in 225 samples (59.1%, 225/381), which 35.1% (79/225) in exon8. Bcl-2–like 11(BIM) deletion were detected in 31 (8.1%, 31/381) white blood cells.
Signaling Pathways
Concurrent gene alterations
Frequency(N=88)
Cell cycle*
CDKN2A
3.9%
CDK4
2.1%
CCNE1
0.8%
CCND1
0.8%
CCND3
0.3%
PI3K/AKT/mTOR*
PIK3CA
2.9%
PTEN
1.3%
TSC1/2
1.0%
AKT2
0.3%
NF1
0.3%
RTKs*
MET
0.8%
HER2
0.8%
FGFR2
0.3%
FGFR3-TACC3
0.3%
Ras/Raf/MAPK*
KRAS
0.8%
Homologous Recombination Repair pathway
BRCA2(sc+gm)
0.8%
BRCA1(sc)
0.5%
ATM
0.5%
PALB2
0.3%
Others
CTNNB1
2.9%
MDM2
2.4%
SMARCA4
0.8%
JAK2
0.5%
sc, somatic mutation;
gm, germline mutation;
*, genes had been reported associated with EGFR-TKIs resistance
8eea62084ca7e541d918e823422bd82e Conclusion
Concurrent gene alterations in treatment-naïve EGFR-mutant advanced NSCLC is common, and mutiple genes are involved. This maybe contribute to the primary resistance to EGFR-TKIs in EGFR-mutant advanced NSCLC. Indicate the importance of multiplex molecular test and further researches of target therapies.
6f8b794f3246b0c1e1780bb4d4d5dc53 -
+
P2.01-131 - Apatinib as an Alternative for Advanced Non-Small Cell Lung Cancer (ID 11784)
16:45 - 18:00 | Presenting Author(s): Jiexia Zhang
- Abstract
Background
Methylsulfonic apatinib showed promising efficacy for the treatment of non–small-cell lung cancer (NSCLC) as one of the TKIs which specifically inhibits VEGFR-2. We aimed to assess the efficacy of apatinib in each lines of treatment to patients with advanced/metastatic NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively analyzed variables and outcomes of patients with advanced NSCLC, who had received apatinib between January 1, 2016 and April 30, 2018, including: 5 patients of first line treatment, 16 second line treatment, 20 third line treatment and 6 fourth and fifth line treatment.
4c3880bb027f159e801041b1021e88e8 Result
The most frequent treatment-related adverse events were hypertension, proteinuria, hand-foot skin reaction and hemoptysis. Among the 47 cases included in the final analysis, the median progression-free survival among patients was 5.66 months specialized in: 0-24.0 months in first line treatment, 0-10.0 in second line treatment, 2.0-10.0 in third line treatment and 0.6-5.4 months in fourth and fifth line treatment. The median overall survival time for apatinib were 25.97 months, 21.4-28.5 months in third line treatment and 0-64.9 months in fourth and fifth line treatment. No significance was found in either PFS and OS among lines of treatment, histology and EGFR mutation status.
Figure 1 PFS and OS of apatinib in different lines of treatment
8eea62084ca7e541d918e823422bd82e Conclusion
The results indicate the administration of apatinib could be used as an alternative for advanced/metastatic NSCLC patients.
6f8b794f3246b0c1e1780bb4d4d5dc53
-
+
P3.13 - Targeted Therapy (Not CME Accredited Session) (ID 979)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
-
+
P3.13-07 - The Effect of Crizotinib in Patients of Non Small Cell Lung Cancer with Brain Metastases: A Retrospective Analysis (ID 11280)
12:00 - 13:30 | Presenting Author(s): Jiexia Zhang
- Abstract
Background
Crizotinib is a tyrosine kinase inhibitor targeting the anaplastic lymphoma kinase gene (ALK) and exhibited a prominent effect in treating ALK-positive non-small cell lung cancer (NSCLC). This retrospective study aimed to evaluate therapeutic effects of crizotinib in patients with brain metastasis (BM) from ALK-positive NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Method
Patients diagnosed with BM caused by ALK-positive NSCLC from November 2010 to October 2015 and treated initially by crizotinib were enrolled and reviewed. The median and 95% confidence interval (CI) of the intracranial and whole-body progression-free survival (PFS) and the overall survival (OS) were calculated by Kaplan-Meier approach. And the candidate prognosticator of the survivals was checked by a log-rank test.
4c3880bb027f159e801041b1021e88e8 Result
Totally 41 patients were eligible for analysis. The median whole-body PFS, intracranial PFS and OS were 8.00 (95% CI, 6.96-9.04), 8.00 (95%, CI 6.99-9.01) and 23.0 (95% CI, 15.8-30.2) months, respectively. Compared with multiple BM, single BM seemed to lead to a better OS when crizotinib was administered (P = 0.029). Totally 5 patients (12.2%) developed crizotinib-related adverse events. Except 1 patient terminated crizotinib treatment because of interstitial pneumonia, the other 4 cases exhibited only adverse events of grade 1.
8eea62084ca7e541d918e823422bd82e Conclusion
Crizotinib could bring an ideal control on BM from ALK-positive NSCLC and were well tolerated. It might be a feasible treatment for patients with this kind of disease.
6f8b794f3246b0c1e1780bb4d4d5dc53
