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Xiaohong Xie
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P1.01 - Advanced NSCLC (ID 158)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.01-10 - Impact of Anti-COPD Support Treatment in Advanced NSCLC Patients with COPD Undergoing Chemotherapy as First-Line Treatment (ID 1603)
09:45 - 18:00 | Author(s): Xiaohong Xie
- Abstract
Background
To investigate the impact of standardized anti-COPD support treatment of advanced NSCLC patients complicate with COPD undergoning chemotherapy as the first-line treatment, which without driver mutations. And putting forword the new concept of "simultaneous treatment of cancer and lung itself".
Method
The clinical data of advanced NSCLC patients complicated with COPD were analyzed retrospectively. And patients were divided into observation group and control group according to whether the patients received standardized anti-COPD support treatment. Compared the survival statistics of the two groups.
Result
The study consisted of 76 patients, only 31 patients received standardized anti-COPD support treatment. The courses of first-line chemotherapy in observation group were more than that of control group (4.8vs.3.8, p＜0.05), and patients in observation group were more likely to received second-line chemotherapy (95.7%vs.75.0%,p＜0.05). Progression-free surival (PFS) and overall survival(OS) of observation group were significantly higher than control group (6.0 months vs.3.5 months,p＜0.05;18.0 months vs.15.0 months,p＜0.05).
Baseline data of two groups of patients Baseline data Observation group Control group Test value P value Sex (Male/Female) 30/1 44/1 χ²=0.072 0.789 Age 67.0±7.2 67.8±7.8 t=0.501 0.667 Smoker 29 43 χ²=0.148 0.700 Smokeing index 880.0±52.5 991±68.6 t=0.76 0.387 Stage χ²=0.473 0.492 IIIB 10 18 IV 21 27 PS （1.97±0.48） （1.93±0.54） -0.285 0.42 Pathological type χ²=0.794 0.373 Adenocarcinoma 14 25 Squamous 17 20 Non-special type 1 2 Pulmonary fuction FEV1%PRED(%) 61.32±6.95 63.49±6.23 t=1.421 0.159 FEC%PRED(%) 58.81±5.73 60.82±4.69 t=1.682 0.097 FEV1/FVC(%) 61.81±5.11 62.89±4.74 t=0.947 0.347 DLCO(%)PRED)(%) 46.42±9.36 47.16±9.73 t=0.329 0.743 Chemotherapy TP 6 12 GP 8 9 DP 8 5 PP 7 16 PP+bevacizumab 2 4 Average courses 4.8 3.8 t=2.589 0.012 Second-line 22 24 χ²=4.170 0.041 The outcome of two groups of patients Curative effect idex
Observation group Control group Test value P value PR 7 10 SD 11 16 PD 13 19 DCR 58.1% 57.8% χ²=0.02 0.889 ORR 22.6 22.2 χ²=0.01 0.971 PFS 6.0 month 3.5 month χ²=3.947 0.047 OS 18.0 month 15.0 month χ²=4.083 0.043 
Conclusion
Advanced NSCLC patients complicate with COPD, which without driver mutations, received standardized anti-COPD support treatment can complete the courses of chemotherapy more smoothly, prolong PFS and OS.
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P2.09 - Pathology (ID 174)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.09-11 - Genomic Profiling of Pulmonary Lymphoepithelioma-Like Carcinoma (PLELC) (ID 1520)
10:15 - 18:15 | Author(s): Xiaohong Xie
- Abstract
Background
PLELC, a rare and distinct type of primary lung cancer, is characterized by Epstein-Barr virus (EBV) infection. Histologically, it resembles undifferentiated nasopharyngeal carcinomas (NPC). Only a few hundred cases have been reported since its discovery. Due to the extreme rareness, its genomic landscape remains elusive.
Method
Tissue samples of 27 PLELC patients (13 males and 14 females) with various stages (Ib to IV) were subjected to targeted sequencing using a panel consisting of 520 cancer-related genes, spanning 1.6Mb of human genome.
Result
Collectively, we identified 184 somatic mutations spanning 109 genes, including 107 SNVs, 12 insertions or deletions (INDELs) and 65 copy-number amplifications (CNAs). Approximately, 50% of patients had CNAs. One patient had no mutation detected from this panel. Except for 2 patients, 1 with HER2 amplification and another with KRAS mutation, no other classic NSCLC driver genes were detected. The most frequently mutated genes were CCND1, TP53, DAXX and NFkBIA, occurring in 30%, 26%, 22% and 22% of patients, respectively. Interestingly, 78% (21/27) patients had mutations in epigenetic regulators. Of the 184 mutations identified, 51 occurred in epigenetics-related genes. Pathway analysis also revealed an enrichment of genes participating in chromatin remodeling and organization. Next, we compared the genomic profile of PLELC with lung adenocarcinoma and EBV positive NPC. The frequency of TP53 mutations was significantly higher in lung adenocarcinoma (68% vs 26%, p=0.021). Comparing to NPC, PLELC had significantly more mutations in epigenetic regulators. TMB analysis revealed a median TMB of 1.6/Mb, significantly lowered than lung adenocarcinomas (p<0.01). We also assessed PD-L1expression and revealed that 67% had an overexpression of PD-L1. Interestingly,TP53-mutant patients were more likely to associated low PD-L1 expression (p<0.01).
Conclusion
In this study, we elucidated a distinct genomic landscape associated with PLELC with no classic NSCLC driver mutation but an enrichment of mutations in epigenetic regulators. The observation of high expression of PD-L1 and lack of canonical druggable driver mutation raises the potential of immunocheckpoint blockade therapy for PLELC.
