Virtual Library
Start Your Search
Bao-Hui Han
Author of
-
+
Lunch & Poster Display session (ID 58)
- Event: ELCC 2019
- Type: Poster Display session
- Track:
- Presentations: 5
- Moderators:
- Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
-
+
142P - Clinical management of advanced lung adenocarcinoma with ALK rearrangement: Real-world treatment outcomes and long-term survival (ID 546)
12:30 - 13:00 | Author(s): Bao-Hui Han
- Abstract
Background
Anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) have been demonstrated to be effective in ALK-rearranged, advanced lung adenocarcinoma patients. However, data from a real-world setting is very limited. The aim of the study was to: a) determine long-term survival in these patients and investigate factors associated with their prognosis; and b) analyze the clinical outcomes of patients who were sequentially treated with next-generation ALK-TKIs.
a9ded1e5ce5d75814730bb4caaf49419 Methods
ALK-rearranged, advanced lung adenocarcinoma patients who were treated with crizotinib were included between January 2013 and December 2016. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan-Meier method. The hazard ratio (HR) for the risk of progression or death was calculated using multivariate Cox regression model.
20c51b5f4e9aeb5334c90ff072e6f928 Results
A total of 5286 patients were screened and 176 eligible patients were included. Median PFS and OS were 12.4 months (95% CI, 10.3-14.6 months) and 45.6 months (95% CI, 37.6-53.7 months), respectively. 36.3% of patients were 5-year survivors. Extrathoracic metastasis before crizotinib treatment was independently associated with worse PFS (HR, 1.77, 95% CI, 1.24-2.53, P < 0.01) and OS (HR, 1.61, 95% CI, 1.02-2.54, P = 0.04). 45 patients were sequentially treated with newer-generation ALK-TKIs, obtaining a statistically longer OS (54.8 months, 95% CI, not calculable) than patients who were solely treated with crizotinib during clinical management (36.6 months, 95% CI, 29.2-43.9 months, P < 0.01).
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Our study provides useful information about ALK-rearranged, advanced lung adenocarcinoma patients treated with ALK-TKIs in a real-world setting.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25 -
+
143P - Role of radiotherapy in management of brain metastases in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC): A single-center retrospective study (ID 257)
12:30 - 13:00 | Author(s): Bao-Hui Han
- Abstract
Background
Targeted therapies provide benefits in ALK-rearranged patients with brain metastases (BM). However, role of radiotherapy in these patients hasn’t been established. This study sought to determine if upfront radiotherapy in combination with targeted therapies can impact patient outcomes.
a9ded1e5ce5d75814730bb4caaf49419 Methods
A total of 60 ALK-rearranged patients with BM were included for analysis. 34 patients developed BM prior to TKIs: 20 patients received radiotherapy followed by crizotinib and 14 received upfront crizotinib. 26 patients developed BM while receiving crizotinib: 13 patients were treated with crizotinib beyond progression after brain radiotherapy and 13 received next-generation TKIs with or without radiotherapy. Overall survival (OS) and intracranial time to progression (IC-TTP) were calculated from the date of BM.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Among patients with BM prior to TKIs, upfront radiotherapy cohort had longer IC-TTP (22.9 vs 8.9 months; p = 0.022) and longer OS (28.6 vs 23.3; p = 0.024) compared to upfront crizotinib cohort. Of patients who developed BM while receiving crizotinib, continuation of crizotinib plus radiotherapy for those without extracranial progression can give another intracranial progression-free time. However, next-generation TKIs cohort showed superior median IC-TTP compared to crizotinib beyond progression (11.4 vs 7.2 months; p = 0.006). Patients treated with radiotherapy followed by second TKIs even had much longer IC-TTP (21.8 vs 7.2 months; p = 0.009), though median IC-TTP of second TKIs without radiotherapy failed to reach statistical significance compared with crizotinib beyond progression (10.4 vs 7.2 months; p = 0.1).
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Upfront radiotherapy provided better outcomes for ALK-positive patients who developed BM before TKIs and during treatment of crizotinib, and should be considered.
b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement
We would like to acknowledge all the patients and their families for their contributions to this study.
934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25 -
+
149P - Efficacy of tyrosine kinase inhibitors (TKIs) in advanced lung adenosquamous carcinoma (ID 291)
12:30 - 13:00 | Author(s): Bao-Hui Han
- Abstract
Background
Adenosquamous carcinoma (ASC) is a rare type of lung cancers, with components of both squamous carcinoma and adenocarcinoma comprising to at least 10% of the tumor. EGFR-TKIs are playing an increasingly important role in the treatment of mutation-positive lung adenocarcinoma. However, the frequency and efficacy of multi-line EGFR-TKIs for ASC patients with sensitive EGFR mutations remain unclear.
a9ded1e5ce5d75814730bb4caaf49419 Methods
From January 2010 to January 2018, patients pathologically diagnosed as lung ASC in Shanghai Chest Hospital were screened. The effectiveness of EGFR-TKIs in advanced ASC patients with EGFR mutation is retrospectively analyzed.
20c51b5f4e9aeb5334c90ff072e6f928 Results
A total of 268 ASC patients were screened and 189 patients were tested for the presence of EGFR mutation. 101 positive patients were identified (53.0%, 95% CI, 46.3-60.6%), of which there are 43 19del, 44 21L858R mutations, 6 compound mutations or rare mutations, the rest lack of specific information. A higher frequency of EGFR mutation was found in younger, female patients who were non-smokers. We retrospectively collected consecutive survival data of 67 advanced ACS patients with EGFR-TKI therapy of different generations. Forty-six (46/52, 88.5%) patients had disease progression after first-generation EGFR-TKI treatment, with a median progression free survival (PFS) of 10.7 months (95% CI, 8.6-12.8 months) and a median duration of treatment (MDT) of 13.1 months (95% CI, 8.4-17.8 months). Median PFS for 15 eligible patients received third-generation TKI treatment was 10.2 months (95% CI, 8.3-12.1 months). Median overall survival (OS) for 14 eligible patients with multi-line EGFR-TKIs treatment was 42.1 months (95% CI, 15.7-68.5 months), compared to median OS of patients without third-generation treatment (25.1 months, 95% CI, 10.7-39.4) months.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Our data suggests the detection of EGFR mutations in patients with ASC, especially in young, female, non-smoking patients. The third-generation EGFR-TKI treatment could be a better choice to improve outcomes of advanced patients after progression of first-generation TKI.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
Minjuan Hu.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25 -
+
170P - Advanced non-small cell lung cancer patients with low tumor mutation burden might derive benefit from anti-programmed cell death (PD)-1 and anti-programmed deathligand 1 (PD-L1) blockade (ID 194)
12:30 - 13:00 | Author(s): Bao-Hui Han
- Abstract
Background
We aimed to investigate the association between tumor mutation burden (TMB) and survival in non-small cell lung cancer (NSCLC) patients with anti–programmed cell death (PD)-1 and anti--programmed cell deathligand 1 (PD-L1) blockade.
a9ded1e5ce5d75814730bb4caaf49419 Methods
Five retrospective cohorts using PD1/PDL1 blockades and The Cancer Genome Atlas (TCGA) lung cancer data set were included in this study. The restricted cubic spline (RCS) analysis was used to explore the association between TMB and survival. The cut-off values for TMB were determined by X-tile software. Primary outcomes were overall survival (OS) and progression-free survival (PFS). The associations between TMB and intratumor heterogeneity, number of segments, fraction of genome alterations, aneuploidy score, and T cell populations were also investigated.
20c51b5f4e9aeb5334c90ff072e6f928 Results
TMB showed an inverted J-shaped curve with survival risk in RCS plot. Two cut-off values were determined by X-tile software in each cohort. In addition to high TMB, low TMB was an independent prognostic indicator for OS and PFS in NSCLC patients treated with PD1/PDL1 blockades. Objective response rate (ORR), disease control rate (DCR), and 1-year OS rate in the low TMB group were higher than that in the medium TMB group. In TCGA lung cancer data set, low TMB was also associated with longer OS in comparison with medium TMB. Furthermore, NSCLC patients with low TMB had significantly lower intratumor heterogeneity, number of segments, fraction of genome alterations, aneuploidy score, T helper type 2 (Th2) cells, and CD8+ T cells, but higher levels of Th1 and Th17 cells.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
NSCLC patients with low TMB might benefit from anti-PD1/PDL1 immunotherapy.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25 -
+
35P - Clinicopathological characteristics with genetic profiling and prognostic analysis of primary lymphoepithelioma-like carcinoma in Chinese south-eastern population (ID 275)
12:30 - 13:00 | Author(s): Bao-Hui Han
- Abstract
Background
Primary lymphoepithelioma-like carcinoma (LELC) is a rare form of lung cancer, since genetic alternations participate in the carcinogenesis in lung cancer, whether critical driver genes such as ROS1 fusion, anaplastic lymphoma kinase (ALK) rearrangement and epidermal growth factor receptor (EGFR) mutation play roles in LELC remains unclear.
a9ded1e5ce5d75814730bb4caaf49419 Methods
We collected a total of 30 LELC samples for genetic and prognosis analysis retrospectively in ShangHai Chest Hospital, EGFR gene mutation, ALK rearrangement and ROS1 fusion status were extracted from digital database. Clinicopathological characteristics with genetic profiling and survival were analyzed.
20c51b5f4e9aeb5334c90ff072e6f928 Results
All samples appeared negative for genes (EGFR, ALK and ROS1) alternations detection. Female gender acted as an independently prognostic factor in poorer disease-free survival (DFS) (P = 0.034), and tumors locate in the left lobe associate with worse DFS in univariate analysis (significant trend, P = 0.051), moreover, serum positive NSE level also indicate a shorter DFS after adjustment (significant trend, P = 0.057). Most of LELC are diagnosed at early stage, with 93.3% (27/30) patients obtained the opportunities for surgery.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Since no classical genetic alternations appeared in present study, more investigations of other genes distributions should be explored in the future for better understanding of this rare subtype of lung cancer. Serum positive NSE level seemed to be a prognostic biomarker for DFS in LELC patients.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25
-
+
Mini Oral session II (ID 63)
- Event: ELCC 2019
- Type: Mini Oral session
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 4/11/2019, 16:40 - 17:40, Room C
-
+
117O - Racial disparities in characteristics and prognosis in Asian versus white patients receiving atezolizumab: An ancillary analysis of POPLAR and OAK studies (ID 339)
16:40 - 17:40 | Author(s): Bao-Hui Han
- Abstract
- Presentation
Background
Racial differences in characteristics and prognosis of Asiatic and White patients receiving immunotherapy have not been well described.
a9ded1e5ce5d75814730bb4caaf49419 Methods
We studied 390 patients from the POPLAR and OAK studies who received atezolizumab with evaluable biomarker parameters retrieved from a subsequent blood-based study. The differences of Asians versus Whites in baseline characteristics, outcomes and genetic mutations of atezolizumab therapy were assessed.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Asiatic and White patients differed in characteristics including smoking history, baseline sum of the longest diameters (BLSLD), EGFR mutation frequency, programmed death-ligand 1 (PD-L1) expression and blood-based tumor mutational burden (bTMB) level. Overall survival (OS) was longer in Asians compared with Whites before (median OS: 18.7 vs. 11.1 mo; P = 0.005) and after (median OS: 20.9 vs. 12.6 mo; P = 0.005) propensity score matching (PSM). Race was an independent prognostic factor for OS (Asian vs White: HR 0.647, 95% CI 0.447-0.936, P = 0.021) in addition to performance status (PS), histology, BLSLD, and number of metastatic sites. The objective response rate (ORR) for Asians and Whites was 8.2% and 17.1%, respectively and disease control rate (DCR) was 51.2% and 47.7%, respectively. The blood-based mutational landscape differentiated between Asians and Whites. In the overall population, mutations of STK11, EGFR, KEAP1, POLE, GRM3, ATM and STAG2 were associated with treatment response while mutations of TP53, KEAP1, APC, RB1, CREBBP, EPHA5 and STAG2 were associated with OS. Comparing the frequency of efficacy- or prognosis- related mutations, Asians had more EGFR mutations and less TP53 and STK11 mutations than Whites.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Asians and Whites differed in the clinicopathological features and mutational landscape which may explain the superior efficacy of atezolizumab in Asiatic patients with NSCLC. This study conveys implications for further studies on racial disparity in the treatment of immunotherapy.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Support (No. 20161434).
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
118O - Blood tumor mutational burden as a predictor of clinical benefit in non-small cell lung cancer patients treated with docetaxel: Secondary analysis of the OAK and POPLAR randomized clinical trials (ID 222)
16:40 - 17:40 | Author(s): Bao-Hui Han
- Abstract
- Presentation
Background
Blood-based tumor mutational burden (bTMB), which is measured by targeted next-generation sequencing (NGS) using cell-free DNA (cfDNA), shows a positive correlation with tissue-based TMB and is a predictive biomarker for non-small cell lung cancer (NSCLC) patients receiving atezolizumab. However, the role of bTMB in other treatment settings, such as chemotherapy, is unknown. We hypothesized that advanced NSCLC patients with low bTMB would derive more benefit from chemotherapy.
a9ded1e5ce5d75814730bb4caaf49419 Methods
The clinical and genetic data from docetaxel arm of OAK trial (n = 318, training cohort) and POPLAR trial (n = 106, validation cohort) were used. The FoundationOne CDx NGS assay was used to quantify bTMB. Efficacy was determined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Durable clinical benefit (DCB) was defined as overall survival (OS) that last more than 12 months. Gene alterations and bTMB were compared among patients with DCB and no durable benefit (NDB). The cut-off value of bTMB for predicting OS was determined by time-dependent receiver operating characteristic (ROC) curve.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Significantly lower bTMB was observed in DCB than NDB (median, 5 vs 9 SNVs/Mb; P < 0.001) and in patients with partial response (PR) versus stable disease (SD) versus progressive disease (PD) (median, 5 vs 7 vs 10 SNVs/Mb; P = 0.007). The optimised cut-off value of bTMB for predicting OS was 7 SNVs/Mb by time-dependent ROC curve. In training cohort, the median OS of patients with low bTMB was 11.5 months and 6.4 months for those with high bTMB (HR 0.638; 95% CI 0.497-0.820; P < 0.001). The median PFS in the low bTMB group (4.3 months) was significantly longer than that in the high bTMB group (2.9 months; HR 0.588; 95% CI 0.466-0.742; P < 0.001). These results were confirmed in validation cohort. Variants in EGFR and KEAP1 associated with DCB and NDB, respectively.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Our data showed that low bTMB (≤ 7 SNVs/Mb) was a clinically biomarker for docetaxel treatment in NSCLC.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
