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Jang-Ming Lee



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    MA20 - Thymic Tumors: From Molecular to Clinical Results and New Challenges in Other Rare Thoracic Tumors (ID 149)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Thymoma/Other Thoracic Malignancies
    • Presentations: 1
    • Now Available
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      MA20.10 - Long-Term Prognostic Factors After Minimally Invasive Esophagectomy (MIE) for Esophageal Cancer (Now Available) (ID 2956)

      11:30 - 13:00  |  Author(s): Jang-Ming Lee

      • Abstract
      • Presentation
      • Slides

      Background

      MIE has been demonstrated to associate a better peri-operative outcome to treat esophageal cancer as compared to that done by open surgery. However, the long-term clinical impact of MIE and its prognostic factors still requires further clarification.

      Method

      In current study, we evaluated the survival results and the factors influencing the prognosis of patients with esophageal cancer who received total minimally invasive esophagectomy using thoracoscopic and laparoscopic esophagectomy and esophageal reconstruction.

      Result

      A total of 483 patients were included in the study with 179 and 304 receiving Ivor Lewis and McKeown MIE respectively. Neoadjuvant chemoradiation was administered to 379 (78 %) of the patients. The overall and disease progression-free survival curves of all the patients were constructed with five-year survival rates of 48.3% and 40.3% respectively. Multivariate analysis revealed that pathological tumor stage was a significant factor for prognosis after surgery both in the patients treated with and without neoadjuvant CCRT (P< 0.05). Of the patients with patholoigical stage I or ypStage I esopahgeal cancer after CCRT, overall survival was significantly improved with the increased number of dissected lymph nodes (P=0.022).

      Conclusion

      The survival of patients with esophageal cancer undergoing MIE was influenced by their tumor staging, irrespective the use of neoadjuvant CCRT. Of these patients with stage I and ypStage I disease, improved survival can be facilitated with increased number of dissected lymph nodes during MIE.

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    P1.15 - Thymoma/Other Thoracic Malignancies (ID 184)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Thymoma/Other Thoracic Malignancies
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.15-03 - Cabozantinib and R428 Inhibit the Growth of Esophageal Squamous Cell Carcinoma (ESCC) (ID 463)

      09:45 - 18:00  |  Author(s): Jang-Ming Lee

      • Abstract

      Background

      Esophageal squamous cell carcinoma (ESCC) is a deadly disease for which no effective targeted therapeutic agent has been approved. Both AXL and c-MET have been reported to be independent prognostic factors for ESCC. Thus, inhibitors of AXL/c-MET might have great potential as targeted therapy for ESCC. We evaluated the efficacy of AXL/c-MET selective inhibitors, R428 (BGM324) and cabozantinib (XL184) in ESCC cell and mouse xenograft models.

      Method

      The cytotoxicities of R428, BMS-777607 and cabozantinib in CE81T and KYSE-70 cells were determined by MTT survival assay. The effect of each inhibitor on migration activity of ESCC cells was analyzed by wound healing assay. ESCC xenograft models were established by injecting KYSE70 cells with matrigel into the upper back region of NOD-SCID male mice followed by treatment with vehicle control, R428 (50 mg/kg/day), cisplatin (1.0 mg/kg) or cabozantinib (30 mg/kg/day) for the indicated number of days.

      Result

      We demonstrated both R428 and cabozantinib significantly inhibit the growth of CE81T and KYSE-70 ESCC cells. R428 but not cabozantinib had a synergistically cytotoxic effect in combination with cisplatin in ESCC cells. Meanwhile, both R428 and cabozantinib inhibited ESCC cell migration by wound-healing assay. In ESCC xenograft models, R428 alone significantly inhibited ESCC tumor growth compared to the vehicle; however, no synergistic effect with cisplatin was observed. Notably, the dramatic efficacy of cabozantinib alone was observed in the mice xenograft model.

      Conclusion

      Our study demonstrated that both cabozantinib and R428 inhibit ESCC growth in cell and xenograft models. The results reveal the great potential of using cabozantinib for targeted therapy of ESCC.

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      P1.15-09 - The Impact of Minimal Invasive Esophagectomy and Neoadjuvant Chemoradiotherapy for Esophageal Malignancy: A Nationwide Database Analysis (ID 2567)

      09:45 - 18:00  |  Author(s): Jang-Ming Lee

      • Abstract

      Background

      Squamous cell carcinoma is the predominant histologic subtype of esophageal cancer in Asia pacific. Radical surgery provides the most realistic chance of cure from cancer of the esophagus. Multimodality treatment, including radiotherapy, chemotherapy and surgery is superior to surgery alone for patients with resectable adenocarcinoma of the esophagus. Recent advances in thoracoscopic surgery have made it possible to perform esophagectomy via minimal invasive surgery. The objective of this study was to evaluate the survival of esophageal squamous malignancy, received minimally invasive esophagectomy, with or without neoadjuvant chemoradiotherapy.

      Method

      From 2010 to 2016, all patients received esophagectomy for esophageal malignancy, in Taiwan, were enrolled into this study. The demographic and outcome data for these patients were retrospectively examined. Logistic regression analysis was used to identify the factors associated with survival.

      Result

      Total 3957 patients received esophagectomy, 2946 of these were performed by minimal invasive method. About 56.8% patients received neoadjuvant chemoradiotherapy. The overall five years survival of all stage patients was 35.9%. The patients, who received minimal invasive esophagectomy, had better five years survival of 37.7%. Stage III patients treated with or without adjuvant chemoradiotherapy, the five years survival was 29.2 and 31.8%. Stage IV patients treated with or without adjuvant chemoradiotherapy, the five years survival was 8.8 and 13.4%.

      Conclusion

      Minimal invasive esophagectomy had better survival in stage I/II patients. Better survival was also noted in stage III/IV patients, when neoadjuvant chemoradiotherapy was applied.