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Chunxia Su



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    JCSE01 - Joint IASLC-CSCO-CAALC Session (ID 63)

    • Event: WCLC 2019
    • Type: Joint IASLC-CSCO-CAALC Session
    • Track:
    • Presentations: 1
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      JCSE01.26 - PD-1 Inhibitor Plus Chemotherapy as 2nd/Subsequent Line Setting Demonstrate Superior Efficacy over PD-1 Inhibitor Alone in Pts of Advanced NSCLC (ID 3863)

      07:00 - 11:15  |  Author(s): Chunxia Su

      • Abstract
      • Slides

      Abstract
      Background
      PD-1/PD-L1 inhibitors have become standard of care as the 2nd-line setting and also approved as 1st line setting when combined with doublet chemotherapy in patients with advanced NSCLC. This study aims to compare the efficacy of PD-1 inhibitor plus chemotherapy with PD-1 inhibitor alone as 2nd/subsequent lines setting in patients with advanced NSCLC

      Methods
      Patients who received PD-1 inhibitor monotherapy or PD-1 inhibitor plus chemotherapy as 2nd/subsequent lines setting in Shanghai Pulmonary Hospital, Tongji University were retrospectively collected. Detailed clinicopathologic characteristics and therapeutic outcomes were analysis.

      Results
      From January 2016 to February 2019, 148 patients who meet the criteria were included. Among them, 116 were in PD-1 inhibitor monotherapy group and 32 were in PD-1 inhibitor plus chemotherapy group. Chemotherapy regimens were pemetrexed(n=9), docetaxel(n=2), nab-paclitaxel(n=18) and gemcitabine(n=3). The baseline characteristics such as age, gender, smoking status, histology, PD-1 mono-antibodies, line of therapy were similar in the 2 groups. Combination group showed a favorable ORR (28.1% vs. 13.8%, p=0.055) and a significantly longer PFS(median 4.9 vs 2.5 months, p=0.005) compared with ICI monotherapy. Overall survial (OS) data was immature in the cutoff date of follow up. In the subgroup of 96 patients (monotherapy group n=69/ Combination group n=27) who were included as 2nd line setting, PD-1 inhibitor plus chemotherapy had significantly higher ORR(ORR:33.3% vs 18.8%, p=0.129) and longer PFS(median PFS: 4.9 vs 2.9 months, p=0.041).



      Conclusion
      PD-1 inhibitor plus chemotherapy as 2nd/subsequent lines setting demonstrated superior efficacy over PD-1 inhibitor alone in patients with advanced NSCLC.

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    P1.01 - Advanced NSCLC (ID 158)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.01-42 - Whole-Exome Sequencing Identifies Novel Somatic Mutations Associated with Prognosis in Lung Cancer Metastatic to the Brain    (ID 988)

      09:45 - 18:00  |  Presenting Author(s): Chunxia Su

      • Abstract
      • Slides

      Background

      Lung cancer is the leading cause of cancer-related mortality in China and worldwide. Patients with lung cancer are the major origin of metastastatic brain tumor. Understanding the difference between primary lung lesion and brain metastases may contribute to the treatment strategy.

      Method

      To investigate the difference of somatic mutations in patients with non–small-cell lung cancer (NSCLC) and brain metastases. Whole-exome sequencing method were used in 13 paired lung cancer and brain metastasis samples from our institute.

      Result

      6,318 SNVs and 56,686 mutation events in 3864 genes were observed in 13 paired lung cancer and brain metastasis samples. We identified 46 driven gene mutations which are most frequently related to lung cancer. Several lung cancer metastases associated genes (KMT2C, BAGE2 and FER1L4) and epigenetic factors (CHEK2P2, miR-4436A, miR-6077) were found as well. A mean of 3.1 driver mutation events per tumor with the dN/dS of 2.06 (95%CI: 1.73-2.4) in these samples which indicating a significant enrichment of the cancer driven mutations. Mutation spectrum analysis found that these samples have more similar transition (Ti) and transversion (Tv) profile,in which C->T transitions is more frequently seen in brain metastasis samples, while lung primary tumor have a higher frequency of C->A transversion. Furthermore we found the most important tumor onset and metastasis pathways in these samples, such as focal adhesion,PI3K-Akt signaling pathway and MAPK signaling pathway. What’s more, Glioma pathway were also identified which highly indicating the solid finding of the study.

      figure 1.jpgfigure 2.jpg

      Conclusion

      In summary, we conducted an exome-wide sequencing through pairwised lung primary and brain metastasis samples and identified some novel cancer and metastasis related mutation which provided potential biomarkers for prognosis and novel therapeutics.

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      P1.01-62 - Association of Baseline Pulmonary Fibrosis with the Outcome of PD-1 Inhibitor in Patients with Advanced Non-Small Cell Lung Cancer (ID 2942)

      09:45 - 18:00  |  Author(s): Chunxia Su

      • Abstract

      Background

      PD-1/PD-L1 inhibitors have become standard care for previously treated advanced non-small cell lung cancer (NSCLC). However, not all patients are suitable for the immunotherapy. This study aimed to investigate the efficacy and safety of PD-1/PD-L1 inhibitors in patients with advanced NSCLC and pre-existing pulmonary fibrosis (PF).

      Method

      Patients who had a NSCLC diagnosis, received anti-PD-1/PD-L1 monotherapy and had baseline chest HRCT screen at Shanghai Pulmonary Hospital, Tongji University were retrospectively collected from January 2016 to February 2019. The pre-existence of PF was identified by reviewing baseline chest imaging. Baseline clinicopathologic characteristics, treatment outcomes and immune-related pneumonitis were collected.

      Result

      116 patients were included with 61 age < 65. Among them, 97 (83.6%) were male, 76 (65.5%) were smoker, 51 (44%) were squamous, 61 (52.6%) received anti-PD-1 monotherapy (Pembolizumab n=62, Nivolumab n=28) as 2nd line setting, 28 (24.1%) had PF prior to PD-1 inhibitors. Baseline characteristics such as age, gender, ECOG PS, smoking history, pathology are similar between patients with or without PF. Patients with PF had a comparable response (ORR: 25% vs 15.9%, p=0.277, figure A), disease control (DCR: 60.7% vs 48.9%, p=0.274, figure B) and PFS (median 2.5 vs 2.8 months, p=0.950). The incidence of immune-related pneumonitis in the entire cohort was 9.2%, which was numerally higher in PF group (17.9% vs 6.8%, p=0.172, figure C). No death from immune-related pneumonitis occurred.

      fig.jpg

      Conclusion

      NSCLC patients with pre-existing PF showed comparable response to PD-1 inhibitors but a higher incidence to immune-related pneumonitis.

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    P1.04 - Immuno-oncology (ID 164)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.04-46 - PD-1 Inhibitor Plus Chemotherapy as 2nd/Subsequent Line Setting Demonstrate Superior Efficacy Over PD-1 Inhibitor Alone in Pts of Advanced NSCLC (ID 2878)

      09:45 - 18:00  |  Author(s): Chunxia Su

      • Abstract

      Background

      PD-1/PD-L1 inhibitors have become standard of care as the 2nd-line setting and also approved as 1st line setting when combined with doublet chemotherapy in patients with advanced NSCLC. This study aims to compare the efficacy of PD-1 inhibitor plus chemotherapy with PD-1 inhibitor alone as 2nd/subsequent lines setting in patients with advanced NSCLC

      Method

      Patients who received PD-1 inhibitor monotherapy or PD-1 inhibitor plus chemotherapy as 2nd/subsequent lines setting in Shanghai Pulmonary Hospital, Tongji University were retrospectively collected. Detailed clinicopathologic characteristics and therapeutic outcomes were analysis.

      Result

      From January 2016 to February 2019, 148 patients who meet the criteria were included. Among them, 116 were in PD-1 inhibitor monotherapy group and 32 were in PD-1 inhibitor plus chemotherapy group. Chemotherapy regimens were pemetrexed(n=9), docetaxel(n=2), nab-paclitaxel(n=18) and gemcitabine(n=3). The baseline characteristics such as age, gender, smoking status, histology, PD-1 mono-antibodies, line of therapy were similar in the 2 groups. Combination group showed a favorable ORR (28.1% vs. 13.8%, p=0.055) and a significantly longer PFS(median 4.9 vs 2.5 months, p=0.005) compared with ICI monotherapy. Overall survial (OS) data was immature in the cutoff date of follow up. In the subgroup of 96 patients (monotherapy group n=69/ Combination group n=27) who were included as 2nd line setting, PD-1 inhibitor plus chemotherapy had significantly higher ORR(ORR:33.3% vs 18.8%, p=0.129) and longer PFS(median PFS: 4.9 vs 2.9 months, p=0.041).

      figure 1.jpg

      Conclusion

      PD-1 inhibitor plus chemotherapy as 2nd/subsequent lines setting demonstrated superior efficacy over PD-1 inhibitor alone in patients with advanced NSCLC.

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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-30 - Hepatitis B Infection or Aminotransferase Increase Associate with Poor Outcome of Anti-PD-1 Monotherapy in Patients with Advanced NSCLC (ID 2508)

      10:15 - 18:15  |  Author(s): Chunxia Su

      • Abstract

      Background

      Previous study demonstrated that the existence of liver metastases at the commencement of immunotherapy was associated with poor response. Since hepatitis B infection and liver dysfunction were higher prevalent in China, this study aimed to investigate the efficacy and safety of PD-1/PD-L1 inhibitor in Chinese NSCLC patients with hepatitis B infection or liver dysfunction.

      Method

      We retrospectively collected the patients who were diagnosed with non-small cell lung cancer and received anti-PD-1 monotherapy at Shanghai Pulmonary Hospital, Tongji University School of Medicine, China, from January 2016 to February 2019. Detailed clinicopathologic characteristics, therapeutic outcomes, hepatitis biomarker test and liver function test were collected.

      Result

      135 patients were enrolled with 73(54.1%) aged <65 years old. Among them, 113(83.7%) were male, 84(62.2%) were smoker, 57(42.2%) were squamous, 69(44.4%) received anti-PD-1 monotherapy (Pembolizumab n=28, Nivolumab n=21) as 2nd line setting, 5(3.7%) patients had hepatitis B infection and 17(12.6%) had increased ALT or AST. The baseline characteristics such as age, gender, smoking status, histology, PD-1 mono-antibodies, line of therapy was similar between hepatitis infection or liver dysfunction group vs. normal group. Hepatitis infection or liver dysfunction group had a lower ORR (9.5% vs. 17.5%, p=0.553, Figure A), significantly shorter PFS (1.6 months vs. 3.0 months, p<0.050, Figure B) when compared with these patients without. Out of the 22 patients with hepatitis or increase transaminase, 35.7% deteriorated the grading of alanine or aspartate aminotransferase increased. 肝炎肝损final (1).jpg

      Conclusion

      NSCLC patients with hepatitis B infection or increased transaminase showed a high incidence of hepatic disfunction and poor outcome to anti-PD-1 monotherapy.