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Tomohisa Sakaue
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-97 - Is Surgical Treatment Suitable for Stage III or IV Primary Lung Cancer? (Now Available) (ID 1269)
08:00 - 18:00 | Author(s): Tomohisa Sakaue
- Abstract
Background
Background: It is generally known that advanced lung cancer is not an indication for surgical treatment, whereas it is an indication for chemotherapy and/or immunotherapy. We examined cases in which surgery was performed for clinical stage III or IV lung cancer and investigated whether this treatment was effective or not.
Method
Methods: We retrospectively reviewed 34 patients who underwent radical resection for stage III or IV primary lung cancer at Ehime University Medical Hospital from October 2010 to February 2019.
Result
Results: In this series, 23, 5, and 6 patients had stage IIIA, stage IIIB, and stage IV disease, respectively. Following were the histological types: adenocarcinoma, 14; squamous cell carcinoma, 9; large-cell carcinoma, 5 (large-cell neuroendocrine carcinoma [LCNEC], 1); adenosquamous carcinoma, 1; pleomorphic carcinoma, 1; LCNEC + adenocarcinoma, 1; LCNEC + squamous cell carcinoma, 1; and LCNEC + small-cell carcinoma, 1. As preoperative treatment, 8 and 7 patients received full-dose chemoradiotherapy (salvage surgery) and induction chemoradiotherapy, respectively. We also included 2 cases involving salvage surgery after only chemotherapy and 1 case involving salvage surgery after chemotherapy and brain metastasis resection. The remaining 16 patients underwent surgery without any pre-surgical treatment. In addition, adjuvant chemotherapy was administered in 17 cases. In a mean observation period of approximately 4 years, the overall 3-year and 5-year survival rates were 57.2% and 30.6%, respectively. In patients with clinical stage IIIA disease, the 3-year and 5-year survival rates were 55.9% and 21.7%, respectively. In patients with clinical stage IIIB disease, the 3-year and 5-year survival rates were 75% and 50%, respectively. In patients with stage IV disease, the 3-year and 5-year survival rates were 50% and 33.3%, respectively. In patients without any multimodal treatments (n = 16), the 3-year and 5-year survival rates were 55.0% and 23.6%, respectively. In patients who underwent surgery after induction chemoradiotherapy (n = 7), the 3-year and 5-year survival rates were 85.8% and 42.9%, respectively. In patients who underwent salvage surgery (n = 11), the 3-year and 5-year survival rates were 41.7% and 41.7%, respectively.
Conclusion
Conclusion: Long-term survival can be achieved even in stage III or IV lung cancer patients by combining multimodal treatment with surgery in appropriate cases.
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EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-27 - Expression Analysis of Programmed Death-Ligand (PD-L) 1 in Large Cell Neuroendocrine Carcinoma (Now Available) (ID 3112)
08:00 - 18:00 | Presenting Author(s): Tomohisa Sakaue
- Abstract
Background
Programmed death (PD)-1/PD-ligand-1 (PD-L1) signaling is main target of immune-checkpoint therapy for lung cancer. Since PD-L1 expression level is known as an important indicator for patient selection of PD-1/PD-L1 blockade therapy, immunohistochemical analysis using anti-PD-L1 antibody were largely performed in various lung cancer tissues. However, there was few evidences regarding expression pattern of PD-L1 in large cell neuroendocrine carcinoma (LCNEC). In this study, we aimed to clarify the tissue distribution of PD-L1, and gene expression pattern between PD-L1-positive and negative cells in LCNEC.
Method
Lung cancer tissues were derived from patients with LCNEC (n=10) and adenocarcinoma (n=8). All tissues were stained with anti-PD-L1 (SP142, Ventana/Roche), CD8 (T lymphocytes), and PD1 antibody using OptiView DAB IHC systems. To investigate the molecular mechanism of overexpression of PD-L1 in LCNEC, we have also performed microarray analysis of PD-L1-positive and -negative cancer cells in the identical LCNEC patient.
Result
From immunohistochemical staining data, while 25% of adenocarcinoma were PD-L1 positive, 80% of LCNEC were strongly stained by anti-PD-L1 antibody. Invasion of PD-1-positive lymphocytes were also seen around PD-L1 positive lung cancer cells. Microarray data showed that antigen-presenting related genes were dominantly up-regulated in the PD-L1-positive cells.
Conclusion
Our data concluded that the patients with LCNEC might be targets for immune-checkpoint therapy using anti-PD-1 neutralizing antibody.
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P1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 186)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.16-37 - Correlation Between the Actual Measurement Value After Lung Lobectomy and the Predicted Value of Forced Expiratory Volume in 1 Second (Now Available) (ID 1717)
09:45 - 18:00 | Author(s): Tomohisa Sakaue
- Abstract
Background
It is important to accurately predict postoperative respiratory function to safely perform lung resection without impairing the postoperative quality of life (QOL), particularly for patients with a significant ventilatory defect. To easily predict the vital capacity (VC) and forced expiratory volume in one second (FEV1), the number of pulmonary segments remaining after lung resection are divided by the total number of pulmonary segments (predicted value of FEV1).
Method
We performed a retrospective review of 386 consecutive lobectomies performed from June 2011 to December 2018 at the Ehime University Hospital. On the basis of the preoperative values of FEV1%, we made 4 groups: FEV1%< 50% (n=16), FEV1% ≥50% but <60% (n=29), FEV1% ≥60% but <70% (n=109), and FEV1% ≥70% (n=232). We compared the difference between the predicted value of FEV1 and the actual measurement value three months after the lobectomy.
Result
The scattergram in Fig 1. shows the correlation between the preoperative FEV1% and the predicted value of FEV1 in all cases. A weak but negative correlation (r=-0.2491) was found between them. Furthermore, in the FEV1% <50% group, the actual measurement value of FEV1 three months after the lobectomy was 253.9 mL larger than the predicted value and was 146.6 mL, 124.8 mL, and 70.4 mL in the FEV1 ≥50% but <60%, FEV1 ≥60% but <70%, and FEV1 ≥70% groups, respectively.
Conclusion
Although this method is convenient and useful in predicting the postoperative respiratory function, it tends to be generally underestimated, especially in patients with a significant ventilatory defect. These results suggest that it is necessary to be careful not to indicate an operable patient as being inoperable on the basis of the predicted FEV1.
