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Masatoshi Kakihana
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P2.11 - Screening and Early Detection (Not CME Accredited Session) (ID 960)
- 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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P2.11-12 - Metabolomic Analysis in Lung Cancer for Screening and Early Detection (ID 12131)
16:45 - 18:00 | Author(s): Masatoshi Kakihana
- Abstract
Background
Metabolomics, a simultaneous measurment technique for hundsleds of low weight molecules, generally called metabolites, is an effective technique to understand how metabolism is changed by various factors, including environment and diseases, particularly malignant diseases. Body fluids, such as urine or saliva, harvested non-invasively have been used in this analytical technology, which yielded a potential of precise diagnosis of various cancers. Metabolomic analysis has begun to be reported based on the pattern information of metabolites. It can be used for practical clinical early detection of carcinoma of various organs. However, practical metabolomic analysis regarding lung cancer has not been repored yet. We used surgically resected specimen of lung cancer to analyze and clarify metabolomic profiles as an aspect of lung cancer.
a9ded1e5ce5d75814730bb4caaf49419 Method
We obtained blood and saliva from 110 patients with lung cancer after obtaining informed consent for this study and compared the metabolomic profiles of both blood and saliva in 83 who has neither pulmonary disease nor past history of any cancer in terms of various clinical aspects. Metabolomic analysis was performed by capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS) of metabolites of the blood and saliva, then analysed ionized sample which contained the most metabolites in primary pathways.
4c3880bb027f159e801041b1021e88e8 Result
Analysis of serum and metabolite organization by CE-TOFMS revealed that the intermediate metabolite levels of several pathways changed markedly in lung cancer blood and saliva. We identified characteristic metabolomic patterns in advanced lung cancer with metabolomic clinical information by analysing the association with the overall metabolism profile.
8eea62084ca7e541d918e823422bd82e Conclusion
We identified metabolomic biomarkers which were characteristic of lung cancer using blood and saliva in this study. At present, we are analysing various body fluids for analysis of lung cancer cases including prognostic implications. Applications to non-invasive, simple, easy and low-cost cancer screening are expected in the future.
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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P3.01-24 - The Importance to Switch from EGFR-TKI to Cytotoxic Chemotherapy for EGFR Mutation-Positive Adenocarcinoma (ID 12819)
12:00 - 13:30 | Author(s): Masatoshi Kakihana
- Abstract
Background
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have become the first-line treatment for EGFR-positive non-small cell lung cancer (NSCLC) patients all over the world. Furthermore, EGFR-positive patients who received not only EGFR-TKI but also chemotherapy have good prognosis. However, transition rate from first-line EGFR-TKI to chemotherapy is low.
a9ded1e5ce5d75814730bb4caaf49419 Method
A total of 229 consecutive patients with adenocarcinoma were treated with EGFR-TKI from January 2010 to December 2016 at Tokyo Medical University Hospital. Among these, 159 patients were analyzed in the present study. After excluding 70 patients (45 patients undergone first-line treatment, 7 received chemoradiotherapy,and 18 received osimertinib). The prognosis according to treatment sequence and the reasons patients could not switch from first-line EGFR-TKIs to chemotherapy were analyzed.
4c3880bb027f159e801041b1021e88e8 Result
The median follow-up period was 22.5 months. Of the total 159 patients, 113 (71%) were female, 114 (72%) were <75 years old, and 86 (54%) showed postoperative recurrence. The most frequent subtypes of EGFR were exon 19 deletion in 84 patients (53%) followed by exon 21 L858R in 54 patients (34%). EGFR-TKIs were administered as a first-line therapy in 93 (58%) patients, and chemotherapy was administered in 66 (42%) patients. The most common first administered EGFR-TKI as a first-line was gefitinib in 133 (84%) of 159 patients. Among the 93 patients who were administered EGFR-TKIs as a first-line treatment, 32 (34%) patients transitioned to chemotherapy. The median survival times (MST) of EGFR-TKIs combined with chemotherapy group and EGFR-TKIs alone group were 59.8 months and 22.5 months, respectively (p < 0.001), and MST of patients who received EGFR-TKIs first and chemotherapy first were 38.8 months and 66.4 months, respectively (p = 0.016). The main reasons patients could not transition to chemotherapy was worsening of performance status followed by the patient’s preference.
8eea62084ca7e541d918e823422bd82e Conclusion
EGFR-TKIs and chemotherapy led to good prognosis in EGFR mutation-positive adenocarcinoma patients. It is necessary to consider the timing to switch the treatment strategy before PS becomes worse.
6f8b794f3246b0c1e1780bb4d4d5dc53
