Virtual Library

Start Your Search

Leanne Harling



Author of

  • +

    MA12 - New Frontiers from Pathology to Genomics (ID 138)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Mesothelioma
    • Presentations: 1
    • Now Available
    • +

      MA12.05 - Genomic Analysis of Long Term Malignant Pleura Mesothelioma Patients Treated with Palliative Chemotherapy (Now Available) (ID 2750)

      14:00 - 15:30  |  Author(s): Leanne Harling

      • Abstract
      • Presentation
      • Slides

      Background

      Malignant Pleural Mesothelioma (MPM) is an aggressive tumor related to asbestos exposure with a median survival of 9 months from diagnosis. The aim of this study was to evaluate correlation between genetic mutations and survival in patients who received only palliative chemotherapy.

      Method

      From 2005 to 2015, 720 patients underwent a surgical pleural biopsy and were diagnosed with malignant pleural mesothelioma. Among these, 27 patients survived longer than 30 months (long survival) from diagnosis and 113 survived less than 30 months. The pleural biopsy of the long term survival patients were reviewed and 12 FFPE samples were considered suitable and matched with 12 FFPE biopsy samples from patients who survived less than 12 months.

      Result

      The DNA of 24 patients was sequenced. One sample did not reach quality to be further considered and was excluded. The mean age of total population was 71.6±8.8 and 15 patients were males (table 1). Eleven patients had a mean overall survival of 5.5 months while 12 patients lived more than 30 months. The mutational analysis identified a total of 428 alterations of which 148, classified as somatic and functional, were further considered. Among these, 85% were missense variants, 8% were variants causing a stop gain, 6% were splice variants. UQCRC1 was significantly associated with a reduced survival of MPM patients (p=0.027); figure 1. Positive trend of correlation was observed between mutations in ACTR1 and CUL1 and short MPM survival. By contrast, no significant correlation was observed between gene mutations and long survival.

      Figure 1.

      figure 1 updated.jpg

      Table 1. patient characteristics.

      Variable

      Long survival

      n=12 (%)

      Short Survival

      n=11 (%)

      P value
      Age (median) 67 72 0.216
      Sex 0.193
      Female 6 (50) 2 (18.2)
      Male 6 (50) 9 (81.8)
      Side 0.684
      Right 7 (58.3) 5 (45.5)
      Left 5 (41.7) 6 (54.5)

      Conclusion

      This is the first study that focusing on MPM patients not suitable for multimodality treatment investigated differences in mutational profile between short and long survivors. Our results suggest a possible role of mitochondria metabolism in mesothelioma aggressiveness.

      Only 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.

      Only Active 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 or select "Add to Cart" and proceed to checkout.

  • +

    P1.13 - Staging (ID 181)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Staging
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
    • +

      P1.13-06 - Impact of Lymph Node Involvement and Tumor Location on Survival Following Resection for pN1/pN2 Non-Small Cell Lung Cancer (ID 848)

      09:45 - 18:00  |  Author(s): Leanne Harling

      • Abstract

      Background

      The aim of this analysis is to validate the proposal for the new N staging system for non-small cell lung cancer and evaluate the impact of cancer location on N disease

      Method

      Between January 2011 and December 2015 2,531 anatomical lung cancer resections were performed. Retrospective analysis of the database identified 449 patients with pathological N1 / N2 disease. Patients with N0 disease, carcinoid, small cell lung cancer or secondary cancer were excluded. Patients with M1a (n=5) were excluded as well.

      Result

      449 patients were enrolled in the analysis. Median age was 68 years (range 37 - 87). There were 197(43.9%) female patients. 63.3% (n=284) of the patients were dead at the time of the analysis. Median overall survival of the population was 36.4 months (range 0.4 – 116 months). N1 disease had a median OS of 41.8 months (range 33 -50 months) and N2 26.9 months (range 19 - 34 months) (p=0.004). Dividing single N1 (N1a), multiple N1 (N1b), single N2 with skip metastases (N2a1), single N2 metastasis with N1 disease (N2a2) and multiple N2 (N2b) there was a statistical significant difference in survival (p=0.048): 41.7 months (range 32 - 51), 39.2 months (range 17 - 61), 33.3 months (range 14 - 52), 25 months (range 10 - 39) and 24.6 motnhs (range 19 -30) respectively.

      Analyzing multiple N2 disease (N2b) with single N1 station involved vs multiple N2 the OS was 18.9 months (range 12-25 ) vs 31.8 months (range 13-49) respectively. Seventy one patients had skip metastasis, the presence or not of skip metastasis alone did not correlate with OS: 32.2 months (range 16 - 47) vs 37.3 mo (range 32.5 – 42 mo) (p=0.7). Analyzing factors related to the N subclassification sex (p=0.24), side (p=0.17) and histology (p=0.26) were not correlated with the N status. The tumor location was instead related with N status (p=0.05)

      Lymph node involvement per tumor location for N1/N2 subgroups
      N1a N1b

      N2a1

      ('skip')

      N2a2 N2b Total
      Left Hilum 24 0 2 4 5 35
      Left upper lobe 63 2 20 23 10 118
      Left lower lobe 30 3 6 12 5 56
      Right hilum 32 3 2 3 11 51
      Right upper lobe 59 6 10 22 15 113
      Middle lobe 6 0 3 4 3 16
      Right lower lobe 25 4 13 9 9 60

      Conclusion

      N staging has a significant impact on survival. The new proposed N staging system better stratifies the survival of lung cancer patients with lymph node involvement. Within the N2 category single or multiple N1 and skip N2 metastasis do not have a statistically significant impact on survival.