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Govind Babu K



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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: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.01-125 - EGFR Mutations by NGS in Advanced Squamous Cell Lung Cancer   (ID 13230)

      16:45 - 18:00  |  Presenting Author(s): Govind Babu K

      • Abstract

      Background

      Targets for Squamous cell lung cancer are none as against adenocarcinomas.Also there is limited data available from ct DNA in these patients

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This prospective observational study looked at patients with squamous cell carcinoma lung, either newly diagnosed or having a progressive disease on prior therapy were enrolled. cf-DNA was extracted from peripheral blood and analyzed for EGFR, KRAS, NRAS, BRAF mutations using NGS.20 ml of the blood sample was collected from the patient prior to the initiation of therapy or at progression.

      4c3880bb027f159e801041b1021e88e8 Result

      Sixteen patients of squamous cell carcinoma lung were enrolled into the study. The mean circulating cell-free tumour DNA extracted from the plasma was 96.6 ng (Range, 15-200 ng). Genomic analysis by NGS on the extracted DNA revealed mutations in the EGFR pathway among 8 (50%) patients. The commonest mutation was Exon 21 Leu858Arg (4 patients). One patient had Exon 20 Thr790Met mutation. One patient had complex mutations with coexisting Exon 21 Leu858Arg and Exon18 Gly719Arg in the same sample. Two patients had KRAS Exon2 Gly12Cys mutation.

      Among the patients with Exon 21 mutation, two patients were treatment naïve and two patients were having a progressive disease (one post Gemcitabine/Carboplatin-based chemotherapy and another post Gemcitabine/Carboplatin and Docetaxel chemotherapy). Patient with complex mutations had progressive disease post Gemcitabine/Carboplatin. Patient with Exon 20 T790M mutation had a hyper-progressive disease post-Nivolumab based regimen. While one patient with KRAS mutation one patient was treatment naive while another had progressive disease post Gemcitabine/Carboplatin-based regimen (Table 2).
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      Two patients with Exon 21 mutations who progressed on earlier lines of treatment received Gefitinib. One patient had progressive disease at 3 months while the other patient succumbed to the disease two months after starting Gefitinib. Treatment Naïve patients with EGFR Exon 21 mutations (N=2) upfront received Gemcitabine and Carboplatin-based chemotherapy. Of this 1 patient is currently progression-free and another patient progressed 6 months post chemotherapy and at progression was started on Gefitinib. Patient has a stable disease after 3 months of treatment and still on gefitinib. Patient with Exon 20 T790M mutation was stated on nab-paclitaxel and succumbed to the illness 6 months later. Patient with complex mutations received Docetaxel as second-line chemotherapy and had a progressive disease 4 months after the initiation of therapy and died.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Treatment options for squamous cell carcinoma lung detection of EGFR mutations helps increase the treatment armamentarium for management of these patients. cf-DNA is a good technique for detecting relevant mutations

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    P3.03 - Biology (Not CME Accredited Session) (ID 969)

    • 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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      P3.03-20 - Circulating Tumor Cell Clustering in Vitro Short-Term Culture Correlates with Poor Survival and Allows Monitoring Response to Treatment (ID 13640)

      12:00 - 13:30  |  Presenting Author(s): Govind Babu K

      • Abstract

      Background

      Circulating tumor cells (CTCs) are putative markers for tumor prognosis and may serve to evaluate patient’s response to chemotherapy. CTCs are often detected as single cells but infrequently as clusters indicative of worse prognosis.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Blood samples were obtained from the 86 breast cancer patients, 52 lung cancer patients.

      The nucleated cells were cultured in ellipsoidal microwells

      The microwells were prepared by placing a cover slip (22mm X 22mm) on a 35mm culture dish. Molten agar (3%) was poured on the top of the cover slip enough to cover it (500µl approx). The ellipsoidal microwell in PDMS (polydimethylsiloxane) was then placed on the top of the cover slip containing the molten agar and allowed it to solidify. The culture conditions were carried at 37°C, 5% CO2 and humidified hypoxic conditions (1% O2). The culture medium was replaced every 48-72 hrs with nominal disturbances to the microwells. Cultures were maintained for 3 weeks and imaged on day 7, 14, 21 with bright field microscope and analyzed the images using (Olympus IX71).

      4c3880bb027f159e801041b1021e88e8 Result

      To correlate cluster formation with survival, samples were obtained from 31 patients with lung cancer. These patients were enrolled, when they were presented with progressive disease since their last treatment regimen but before commencing a new treatment regimen. Blood was collected before and on 9th, 12th week after the treatment. It is interesting to note that tight cluster formation correlated with patient survival. The Kaplan-Meier survival analysis showed that cluster formation in patients who have undergone neoadjuvant therapy correlated with shorter overall survival Our culture system enabled us to successfully expand the CTCs without any prior enrichment. The method requires 2.5 ml of blood per 35-mm dish to expand CTCs. Microwells were easy to establish and replicate with minimal set-up in a laboratory.

      8eea62084ca7e541d918e823422bd82e Conclusion

      To the best of our knowledge, this study is one of the few, which suggest the possible role of cluster formation in patient survival in Lung cancer patients.

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