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zhang shao Zhou
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Lunch & Poster Display session (ID 58)
- Event: ELCC 2019
- Type: Poster Display session
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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130P - Relationship of clinicopathological characteristics, EGFR genotyping and prognosis in non-small cell lung cancer patients with malignant pleural effusion (ID 469)
12:30 - 13:00 | Author(s): zhang shao Zhou
- Abstract
Background
To investigate the relationship of the clinical characteristics, EGFR genotyping and prognostic factors of malignant pleural effusion associated with non-small cell lung cancer (NSCLC).
a9ded1e5ce5d75814730bb4caaf49419 Methods
A total of 321 patients hospitalized in Guangxi Medical University Affiliated Tumor Hospital from November 2013 to December 2017 who were pathologically or cytologically confirmed NSCLC with malignant pleural effusion (MPE) were enrolled in the study. The information including clinical features at baseline, pleural effusion status, EGFR genomic alternation, treatment and prognosis for patients were retrospectively extracted and analyzed. The data were analyzed by SPSS 21.0 software. Chi-square test was used for comparison between groups, and Fisher’s exact probability method was used for correction. Survival curves were drawn by Kaplan-Meier method, and the differences between groups were compared by log-rank test. P < 0.05 was considered as statistical significance.
20c51b5f4e9aeb5334c90ff072e6f928 Results
There were significant differences in M staging, ECOG score and bone metastasis between patients with malignant pleural effusion at initial diagnosis and those with malignant pleural effusion at diseases progression (P < 0.05). The median overall survival for EGFR exon 19 deletion mutation, exon 21 L858R mutation and wild type in MPE patients were 21.8 months, 19.5 months and 11.6 months respectively (P = 0.005). The median overall survival for patients with EGFR sensitizing mutations treated with first- and second- generation EGFR-TKIs and those without TKI treatment was 21.9 months and 12.9 months respectively (P = 0.001). The median overall survival for wild type EGFR patients with simultaneous liver metastasis and non-liver metastasis was 5.8 months and 12.2 months respectively (
fd69c5cf902969e6fb71d043085ddee6 ConclusionsP = 0.031).
Through comparing clinicopathological characteristics, EGFR genotyping and prognosis in MPE patients, those whose MPE were identified at the time of diagnosis are more frequently a higher incidence of ECOG score and bone metastasis, a longer OS in patients with EGFR mutation and treated with EGFR-TKI, and a significantly lower OS in patients with wild-type EGFR and liver metastasis.
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 -
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137P - Detection and clinicopathologic features of ctDNA in T790M-positive advanced lung adenocarcinomas patients after failure of treatment with first- and second-generation EGFR-TKIs (ID 359)
12:30 - 13:00 | Author(s): zhang shao Zhou
- Abstract
Background
We aimed to detect ctDNA in patients with advanced lung adenocarcinomas after failure of treatment with first- and second-generation EGFR-TKIs and to analyze it’s clinicopathologic features in a subset of patients harbouring the T790M mutation.
a9ded1e5ce5d75814730bb4caaf49419 Methods
We retrospectively collected data from November 2016 to October 2018 in patients with lung adenocarcinomas who had been analysed by Next-Generation Sequencing or ddPCR after progression on EGFR-TKIs at GuangXi Medical University Affiliated Tumor Hospital. Statistical analyses were performed to examine the associations between clinicopathologic features and acquired T790M mutation in patients.
20c51b5f4e9aeb5334c90ff072e6f928 Results
A total of 72 plasma samples were collected, of which 17 had matched tissue biopsies. Of these patients, 48 were analysed by NGS and the rest by ddPCR. The T790M mutation was detected in 43 cases (59.7%). We found this mutation was higher than that of mPFS>11.5 months (79% vs. 44%; odds ratio, 4.516; 95%CI, 1.53 to 13.30; p=0.006), and in which longer median PFS (13.0 months vs. 9.0 months; p = 0.042). Those who received chemotherapy before EGFR-TKIs were more likely to have the T790M mutation (80% vs. 53%, p=0.03) compared to those who received EGFR-TKIs in the first-line. In this study, the occurrence of T790M mutation in patients with L858R mutation was higher than seen in patients with 19-del (65% vs.57%; p=0.809). Among 17 patients who were sequenced by NGS in both samples, 7 had T790M positive blood samples and 8 were T790M positive in tissue biopsies. The coincidence rate was 94%.10 cases after the progression of the third generation TKI treatment. Three cases of T790M with C797S cis-mutation were detected and 3 cases with PIK3CA, BRAF V600E and MAP2K1 mutations, respectively. Secondary resistance mutations were not detected by NGS in 4 cases.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Patients with advanced lung adenocarcinomas harbouring the T790M mutation who failed with first- or second-generation EGFR-TKIs were more likely to have longer mPFS. In this study, NGS testing using ctDNA was a feasible means for monitoring acquired resistance mutations during or after progression on targeted therapy.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
Cancer Hospital of Guangxi Medical University.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25
