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Hagiwara Masaru



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    EP1.14 - Targeted Therapy (ID 204)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Targeted Therapy
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.14-23 - Comparison of Molecular Testing Using Various Specimens for Non-Small Cell Lung Cancers (Now Available) (ID 2767)

      08:00 - 18:00  |  Author(s): Hagiwara Masaru

      • Abstract
      • Slides

      Background

      The effectiveness of various molecular target drugs such as EGFR-TKI for non-small lung cancers came to be shown. So we performed a genetic tests to make plan for suitable therapy individually. For the cases that an operation was carried out for the lung cancer, I inspected the usefulness of the liquid biopsy. The somatic cell variation rate of detection in blood was low, and, in the relatively early non-small-cell lung cancer patient targeted for the operation, the tumor volume was shown in the rule factor when it was. I examined it including the lung cancer case that moved an object as well as an early case this time.

      Method

      Patients provided written informed consent for use of the samples were participated in this prospective research. EGFR mutation was examined using blood, a liquid cytological specimen, biopsy specimen. These patients was suspected lung cancer and bronchoscopy was performed. We collected blood, the cytodiagnosis specimen using liquid fixed vial for Cellprep and biopsy specimen. I examined EGFR mutations by three kinds of specimens using Cobas EGFR variation detection kit v2.0. We compared results of EGFR mutation,

      Result

      One-hundred fifty-eight patients were registered to this study. Among those patients, 77 patients with matched set of samples were enrolled to this study. EGFR mutation rates in tissue, cytology, and plasma were 37.7, 29.9 and 16.9 %, respectively. Overall agreement rate of the cytology specimens and the plasma specimens against the tissue samples were 87.0 and 75.3%, respectively. All eightT790M mutation positive cases were perfectly matched between tissue and cytology specimens.

      Conclusion

      We previously reported that detection of mutations in cfDNA of patients with disease at stage IA or IB or at T2a or lower is difficult. Tumor volume is a determining factor for the feasibility of mutation detection with cfDNA. In this study, advanced lung cancer patients were included. Biopsy specimen were the most feasible sample for detecting mutations. Since high specificities were confirmed in both cytology and plasma specimens, the results are reliable if the mutation results were positive. Choosing cytology or plasma specimens for EGFR testing can be the considerations for the patients who have difficulties in collecting tissue samples in the real world setting.

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    EP1.17 - Treatment of Early Stage/Localized Disease (ID 207)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.17-36 - Skin Fluorescence Following Photodynamic Therapy with Talaporfin Sodium (Now Available) (ID 1471)

      08:00 - 18:00  |  Author(s): Hagiwara Masaru

      • Abstract
      • Slides

      Background

      The purpose of this study was to establish a sensing to estimate relative talaporfin sodium concentrations in the skin using percutaneous fluorescence spectroscopy, to evaluate the risk of photosensitivity after photodynamic therapy (PDT) for lung cancer.Therefore, we conducted a prospective study to investigate whether talaporfin sodium fluorescence intensity in the skin after PDT could be measured effectively in human lung cancer patients to improve their management during their photosensitive period.

      Method

      Talaporfin sodium fluorescence was measured on the inside of the arm using the fluorescence sensing system that we established prior to and 5 and 10 min after talaporfin sodium administration, as well as at the time of PDT (4–5 h after administration), at discharge (2 or 3 days after PDT), and at 1 or 2 weeks after PDT.

      A total of 10 patients with lung cancer were analyzed. All measurements of talaporfin sodium fluorescence in the skin were obtained without any complications. Spectral peaks were detected at the time of discharge (2–3 days after administration) in most patients or at 1 or 2 weeks after PDT.

      Result

      The fluorescence peak increased with time after talaporfin sodium injection and decreased after a certain peak that was found 48-72 h after talaporfin sodium. The integration of the differential spectrum between obtained spectrum and reference spectrum was calculated to evaluate talaporfin sodium fluorescence in skin tissue.

      Conclusion

      The fluorescence of talaporfin sodium in the skin was readily detected in human patients using our newly established fluorescence sensing system. Furthermore, measuring the relative concentrations of talaporfin sodium indirectly in the skin by measuring fluorescence intensity may be useful for predicting the period of skin photosensitivity after PDT.

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    MA06 - Challenges in the Treatment of Early Stage NSCLC (ID 124)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Now Available
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      MA06.05 - Predictive Performance of Quantitative Metabolic Metrics of FDG-PET/CT on Survival and the Effect of Adjuvant Chemotherapy in Lung Cancer (Now Available) (ID 1294)

      13:30 - 15:00  |  Author(s): Hagiwara Masaru

      • Abstract
      • Presentation
      • Slides

      Background

      Growing evidence suggests metabolic metrics of tumors, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on FDG-PET/CT, reflect the malignancy of early-staged lung cancer. We aimed to investigate the role of metabolic metrics in predicting prognosis and response to adjuvant chemotherapy in pathological stage I (the 7th Edition of TNM Staging of Lung Cancer) lung adenocarcinoma (p-I Ad).

      Method

      The study included 452 patients with p-I Ad who underwent FDG-PET/CT followed by complete resection between July 2012 and December 2017. In this study, MTV is defined as the total tumor volume with an SUV > 2.5 while TLG is calculated as mean of SUV x MTV. The three metabolic metrics measured by a three-dimensional workstation and clinico-pathological factors were analyzed to identify the factors associated with unfavorable overall survival (OS) and recurrence-free survival (RFS). We assessed whether the metabolic metrics were associated with response to oral adjuvant chemotherapy with uracil-tegafur (AC with UFT) in patients with p-I Ad amenable to the treatment.

      Result

      All the three metabolic metrics were significantly correlated with unfavorable OS and RFS on univariate analyses (SUVmax; p=0.047 / p<0.001, MTV2.5; p=0.003 / p<0.001, TLG2.5; p=0.005 / p<0.001). On multivariate analyses, smoking status (p=0.043), the value of serum CEA (p < 0.001), and SUVmax (p=0.001) were independent determinants for poorer RFS while gender (p=0.013) and MTV2.5 (p=0.028) were independent significant factors for unfavorable OS. The receiver operating characteristic areas under the curves for SUVmax, MTV2.5, and TLG2.5 relevant to recurrence were 0.901, 0.849, and 0.872, respectively. Among 239 patients who fitted the criteria of AC with UFT (p-IA > 2cm or p-IB), 80 patients (33.4%) received the treatment (250 mg of tegafur per square meter of body-surface area per day). Although the administration of AC with UFT did not significantly affect RFS and OS (p=0.411 and 0.753), patients with TLG2.5 > 12.8, which value corresponded to the cut-off level, who were not given AC with UFT exhibited worse RFS than those who received the treatment (5-year RFS rate of 72.1% vs. 92.7%; p=0.041).figure.png

      Conclusion

      Metabolic metrics on FDG-PET/CT such as SUVmax, MTV, and TLG enable us to estimate survival outcomes and the effectiveness of AC with UFT in patients with p-I Ad. Patients with metabolically active tumors should be considered high risk, and this information can be useful for the selection of appropriate therapeutic strategy including AC with UFT.

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    P2.17 - Treatment of Early Stage/Localized Disease (ID 189)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.17-39 - Relationship Between EGFR Mutation and Pathological Differentiation in Patients with Clinical Stage IA Lung Adenocarcinoma (ID 3008)

      10:15 - 18:15  |  Author(s): Hagiwara Masaru

      • Abstract

      Background

      Pathological differentiation is an established prognostic factor for patients with lung

      adenocarcinoma. There are some correlations between epidermal growth factor receptor

      (EGFR) mutations and pathological differentiation. EGFR mutation-positive

      adenocarcinoma is considered to be highly differentiated types that show development

      of alveolar epithelial substitution. However, the distribution of pathological

      differentiation and the prognostic impact of the presence or absence of EGFR mutations

      in early adenocarcinoma are not clear.

      Method

      We collected the records of 569 patients who underwent surgical resection for clinical

      stage ⅠA lung adenocarcinoma between 2008 and 2015, and were also examined their

      EGFR mutation status.

      Based on the presence or absence of EGFR mutations and pathological differentiation

      (well;G1/moderately;G2/poorly;G3), patients were categorized into 6 groups: EGFR

      mutation positive (E+) with G1, E+ with G2, E+ with G3, EGFR mutation negative (E-)

      with G1, E- with G2, E- with G3. We examined the distribution of each group, 

      clinicopathological features and prognosis.

      Result

      303 lung adenocarcinoma had EGFR mutations. The distribution was

      E+/G1:85,E+/G2:209,E+/G3:9,E-/G1:50,E-/G2:178,E-/G3:38. E+/G3 group was

      significantly fewer (P<0.001). The 5-year recurrence-free survival (RFS) rates were

      95% in E+/G1 group, 78% in E+/G2 group, 33% in E+/G3 group, 100% in E-/G1

      group, 75% in E-/G2 group, 61% in E-/G3 group. The 5-year overall survival (OS) rates

      were 98% in E+/G1 group, 91% in E+/G2 group, 44% in E+/G3 group, 100% in E-/G1

      group, 87% in E-/G2 group, 79% in E-/G3 group. The prognosis was significantly

      worse in the E+/G3 group. There were more women (77%) and non-smokers (89%) in

      the E+/G3 group. Six patients (66%) had recurrence, and in all cases EGFR-TKI was

      administered and the response rate was 100%.

      Conclusion

      Most of the c-IA EGFR positive adenocarcinomas were highly differentiated, and

      significantly fewer poorly differentiated cases. Among the poorly differentiated group,

      EGFR gene mutation positive is particularly poor prognosis. However, The therapeutic

      effect of EGFR-TKI was not different from other EGFR positive patients.