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Xianghua Wu
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JCSE01 - Joint IASLC-CSCO-CAALC Session (ID 63)
- Event: WCLC 2019
- Type: Joint IASLC-CSCO-CAALC Session
- Track:
- Presentations: 1
- Moderators:Chunxue Bai, Tony Mok, Yi-Long Wu, Qing Zhou, Nan Wu
- Coordinates: 9/07/2019, 07:00 - 11:15, Toronto (1985)
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JCSE01.18 - A CT-Based Radiomics Approach to Predict PD1 Inhibitor Response in Non-Small-Cell Lung Cancer (ID 3432)
07:00 - 11:15 | Author(s): Xianghua Wu
- Abstract
Abstract
Background
The purpose of this study was to investigate the use of radiomics features as predictive parameters of clinical outcomes of non-small-cell lung cancer (NSCLC) patients treated with PD1 inhibitor.
Methods
Forty-three stage IIIB/IV NSCLC patients without EGFR mutation or ALK rearrangement who received nivolumab were enrolled between Apr 2016 and Jan 2019. High-dimensional quantitative feature analysis via Pyradiomics was applied to extract 852 radiomics features of pre-anti-PD1 treatment CT. A radiomic score model was constructed from these features with the use of least absolute shrinkage and selection operator (LASSO) Cox regression. The radiomic score for each patient was computed using an equation in which the coefficients were derived from the LASSO Cox model to subgroup patients by progression-free survival (PFS). The median value of radiomic score was used as the cut-off value to cluster patients into high or low score groups.
Results
We developed a radiomic signature for PFS that included seven variables. The median value of radiomic score was 0.23. The objective response rate (ORR) was 16.3% (7/43), the median PFS was 2 months and median overall survival (OS) was 3.2 months of all 43 patients. A low radiomic score was associated with a higher ORR (33.7% vs 0%, p= 0.0036), improved PFS (median: 3 months vs 2 months; HR 0.14, 95% CI 0.053-0.39, P < 0.0001) and longer OS (median: 11.2 months vs 7.0 months; HR 0.12, 95%CI 0.04-0.31, p < 0.0001). Multivariate analysis also showed that a low radiomic score was related to better PFS (HR 0.12, 95% CI 0.041-0.32, P < 0.0001) and OS (HR 0.11, 95%CI 0.03-0.28, p < 0.0001).
Conclusion
The radiomic signature as an imaging predictor provided a promising way to predict clinical outcomes for NSCLC patients treated with PD-1 inhibitor.
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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
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.01-66 - A CT-Based Radiomics Approach to Predict PD1 Inhibitor Response in Non-Small-Cell Lung Cancer (Now Available) (ID 565)
09:45 - 18:00 | Author(s): Xianghua Wu
- Abstract
Background
The purpose of this study was to investigate the use of radiomics features as predictive parameters of clinical outcomes of non-small-cell lung cancer (NSCLC) patients treated with PD1 inhibitor.
Method
Forty-three stage IIIB/IV NSCLC patients without EGFR mutation or ALK rearrangement who received nivolumab were enrolled between Apr 2016 and Jan 2019. High-dimensional quantitative feature analysis via Pyradiomics was applied to extract 852 radiomics features of pre-anti-PD1 treatment CT. A radiomic score model was constructed from these features with the use of least absolute shrinkage and selection operator (LASSO) Cox regression. The radiomic score for each patient was computed using an equation in which the coefficients were derived from the LASSO Cox model to subgroup patients by progression-free survival (PFS). The median value of radiomic score was used as the cut-off value to cluster patients into high or low score groups.
Result
We developed a radiomic signature for PFS that included seven variables. The median value of radiomic score was 0.23. The objective response rate (ORR) was 16.3% (7/43), the median PFS was 2 months and median overall survival (OS) was 3.2 months of all 43 patients. A low radiomic score was associated with a higher ORR (33.7% vs 0%, p= 0.0036), improved PFS (median: 3 months vs 2 months; HR 0.14, 95% CI 0.053-0.39, P < 0.0001) and longer OS (median: 11.2 months vs 7.0 months; HR 0.12, 95%CI 0.04-0.31, p < 0.0001). Multivariate analysis also showed that a low radiomic score was related to better PFS (HR 0.12, 95% CI 0.041-0.32, P < 0.0001) and OS (HR 0.11, 95%CI 0.03-0.28, p < 0.0001).
Conclusion
The radiomic signature as an imaging predictor provided a promising way to predict clinical outcomes for NSCLC patients treated with PD-1 inhibitor.
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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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P1.04-20 - PD-L1 mRNA Derived from Tumor-Educated Platelets Predicts the Clinical Outcome of Immunotherapy in Non-Small Cell Lung Cancer (ID 2982)
09:45 - 18:00 | Author(s): Xianghua Wu
- Abstract
Background
Immunotherapy was promising treatment of advanced non-small cell lung cancer (NSCLC), but only a small part of patients could benefit from the immune checkpoint inhibitors (ICIs). Development of novel biomarkers was of great importance to improve the selection of patients and to avoid unnecessary toxicity.
Method
We collected data from advanced NSCLC patients who received immunotherapy alone or in combination with chemotherapy as first- or second-line treatment at a single institution. All the patients were wild type of EGFR/ALK and enrolled into clinical trials on ICIs, including nivolumab, pembrolizumab, atezolizumab, durvalumab, tremelimumab and camrelizumab. PD-L1 messenger RNA (mRNA) was detected from tumor-educated platelets before ICIs treatment. Meanwhile, tumoral PD-L1 expression was also determined by immunohistochemistry in archived tissue samples to explore its predictive value and association with TEPs- derived PD-L1 mRNA expression.
Result
Of 76 patients enrolled into this study, 68 patients (89.5%) received only immunotherapy and 23 patients (30.3%) responded to the treatment, and the median PFS was 3.81 months. There was no correlation between tumoral PD-L1 expression and TEPs-derived mRNA of PD-L1 by Pearson Correlation test (P=0.32). Based on the median of PD-L1 mRNA, 19 patients (44.4%) responded to immunotherapy in high PD-L1 group compared to 5 patients (13.9%) in low PD-L1 group (P<0.01). The median PFS were 2.76 months in low PD-L1 group, compared to 8.28 months in high PD-L1 group (P<0.001), respectively. For the 64 patients who received only immunotherapy, the PFS advantage was persistent in high PD-L1 group (2.76 vs 8.02 months, p=0.002). The median OS was not reached in high PD-L1 group, while it was 13.47 months in low PD-L1 group (P<0.01).
Conclusion
Tumor-educated platelets derived PD-L1 mRNA could be a surrogate biomarker predicting the PFS and OS of immunotherapy in patients with advanced non-small cell lung cancer.
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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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P2.09-08 - Correlation Between Hormone Receptor Expression and EGFR Gene Mutation in Lung Cancer Patients with Simultaneous Primary Breast Cancer (ID 2968)
10:15 - 18:15 | Author(s): Xianghua Wu
- Abstract
Background
Double primary breast cancer (BC) and lung cancer (LC) is not uncommon but research is limited. To decipher the inner pathogenesis, relationship between hormone receptor (HR) protein expression and EGFR gene mutation was explored in the present study.
Method
Clinicopathological characteristics of 400 female patients with double primary BC and LC were analyzed, while another 114 patients with single LC were compared correspondingly. Tissue samples were obtained from enrolled subjects to detect EGFR mutation status by gene sequencing analysis, and estrogen receptor (ER) and progesterone receptor (PR) expression was determined by immunohistochemistry.
Result
Among 169 patients, synchronous and metachronous double primary BC-LC cases accounted for 39.1% and 61.0%, respectively. For most female LC patients with simultaneous primary BC, adenocarcinoma was the dominant subtype (95.1%). The positivity rates were 13% for ER and 13% for PR in lung tumor tissues of 200 double BC-LC patients, slightly higher than those in single LC patients. Among BC-LC patients with mutant EGFR, 48.2% were either ER-positive (30.6%) or PR-positive (30.6%). But for those without EGFR mutation, both ER and PR could not be detected in lung tumor tissue samples. χ2 testfurther confirmed a significantly positive correlation between ER, PR expression and EGFR mutation in lung tumor tissues in double primary patients (P < 0.05). However, such relationship could not be similarly observed in single LC cases. Besides, the presence of family tumor history was associated with the onset time of the two primary cancers.
Conclusion
Double primary BC-LC patients have distinctive clinicopathological features. Expression of HRs (both ER and PR) significantly correlated with EGFR mutation status in their lung tumor tissues.
