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Ping Yang
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P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)
- 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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P2.04-06 - Increased Plasma Cell % and Decreased B-Cells in Tumor Immune Infiltrates Are Associated with Worse Prognosis in Lung Adenocarcinomas (ID 12303)
16:45 - 18:00 | Author(s): Ping Yang
- Abstract
Background
Clinical significance of tumor-infiltrating plasma cells and B-cells in lung adenocarcinoma is not well known.
a9ded1e5ce5d75814730bb4caaf49419 Method
CD3, CD20 and MUM1 immunostains were performed on representative tumor blocks selected from 120 consecutive lung adenocarcinoma cases resected. CD3-positive T-cells, CD20-positive B-cells, and MUM1-positive plasma cells were separately enumerated in the intraepithelial (IE) compartment and the stroma (ST) by digital image analyses. Distribution of measured tumor-infiltrating cells was systematically evaluated and their associations with patient’s overall survival (OS) modeled using Cox proportional hazards analysis.
4c3880bb027f159e801041b1021e88e8 Result
Median age of patients was 69 years (range, 46-91 years) and 52 patients were male. Eighty-two, 17, and 21 patients were tumor stage I, II, and III/IV, respectively. Ninety patients had surgery only; 30 had surgery with adjuvant chemotherapy and/or radiation therapy. Median numbers (interquartile range) of CD20-positive B-cells per 1mm2 in the tumor area (IE plus ST) and in IE compartment were 590 (224-1276) and 101 (38-109), respectively; the corresponding numbers of MUM1-positive plasma cells were 298 (180-605), and 67 (22-145), respectively. The percent of MUM1-positive plasma cells among all tumor immune infiltrate (i.e. MUM1-positive cells/[CD3-positive cells + CD20-positive cells + MUM1- positive cells] x 100) ranged from 0 to 60% (median 10%) in the tumor area and showed a significant association with OS by univariate Cox analysis (continuous variable; negative correlation with HR=12.50 [95% confidence interval [CI], 1.75-89.27]). There was a significant association between IE CD20-positive B-cells and the patient’s OS in univariate analysis (continuous variable; positive correlation with hazard ratio [HR]=0.81 (95% CI, 0.68-0.96). Both parameters remained significant by multivariate analysis. Cut-off points (low vs high) showing significant associations with patient’s OS were found by log-rank test (Table 1).
8eea62084ca7e541d918e823422bd82e ConclusionTable 1. Summary of Cox proportional hazards analysis for overall survival
CD20 cells, intraepithelial
MUM1/(CD3+CD20+MUM1),
intraepithelial and stromal
Cut-offs (number)
HR (95% CI)
p
Cut-offs
(%)
HR (95% CI)
p
>72.13
0.63(0.37-0.04)
0.070
>20.4%
1.65(0.98-2.79)
0.063
<72.13
--
<20.4%
>75.49
0.59(0.36-0.99)
0.045
>21.1%
1.71(1.01-2.90)
0.047
<75.49
--
<21.1%
--
>85.66
0.49 (0.29,0.83)
0.007
>24.79%
2.29 (1.33,3.94)
0.003
<85.66
--
<24.79%
--
>101.55
0.57(0.34,0.96)
0.034
>26.0%
2.00(1.07-3.75)
0.031
<101.55
--
<26.0%
--
>101.80
0.65(0.39,1.09)
0.105
>26.4%
1.83(0.97-3.45)
0.064
<101.80
--
<26.4%
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High plasma cell % among immune infiltrate in the tumor area and low IE B-cell count were associated with worse prognosis in lung adenocarcinoma patients.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)
- 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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P3.11-27 - Lung Cancer Diagnosed at Age 50-54 Years: Survival as Poor as Older Patients (ID 14233)
12:00 - 13:30 | Presenting Author(s): Ping Yang
- Abstract
Background
The United States Preventive Services Task Force (USPSTF) recommends lung cancer screening with low-dose computed tomography among people aged 55-80 years with a 30 pack-year cigarette smoking history and, if stopped smoking, quitted within 15 years. We previously identified a prominent subpopulation that would have been too young (i.e., 50-54.9 years) yet otherwise met the USPSTF criteria and were diagnosed with lung cancer. We assessed survival outcomes in these younger patients compared to those eligible for USPSTF lung cancer screening.
a9ded1e5ce5d75814730bb4caaf49419 Method
We studied two cohorts of 7,390 primary lung cancer patients: a Hospital Cohort from Mayo Clinic Rochester (n=6,554) and a Community Cohort from the Olmsted County population (n=836, Minnesota, USA). All patients were diagnosed between age 50 and 80 years, had >30 pack-year smoking history and had quitted <15 years if they had stopped smoking. Two cohorts were analyzed independently to evaluate the impact of younger age (50-54.9 years) on overall survival using Cox Proportional Hazard models by hazard ratio (HR) and 95% confidence interval (CI). Known prognostic factors (age, sex, tumor stage and treatment) were adjusted. To control for age gap, the USPSTF group was subdivided into a 55–69 age subgroup (lower age USPSTF subgroup) and a 70–80 age subgroup (higher age USPSTF subgroup).
4c3880bb027f159e801041b1021e88e8 Result
In both cohorts, the younger age group had at least the same risk of death as patients who met the USPSTF criteria; HR=1.16 for both cohorts; p=0.08 for the Hospital Cohort and p=0.52 for the Community Cohort. Age-group stratified analyses did not change the results in either cohort.
8eea62084ca7e541d918e823422bd82e Conclusion
People who are 50-54.9 years of age and otherwise meet the USPSTF screening criteria for lung cancer, once diagnosed, experience a similar or potentially worse survival outcome as older patients. Benefit of screening in this younger population deserves consideration and futher study.
6f8b794f3246b0c1e1780bb4d4d5dc53
