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Andika Chandra Putra



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    EP1.14 - Targeted Therapy (ID 204)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Targeted Therapy
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.14-41 - Case Series: Lung Neuroendocrine Carcinoma with EGFR Mutation (Now Available) (ID 1589)

      08:00 - 18:00  |  Author(s): Andika Chandra Putra

      • Abstract
      • Slides

      Background

      Lung Neuroendocrine Tumor derived from neuroendocrine cells in the lung and could be classified as well differentiated (low-grade typical carcinoids [TCs] and intermediate-grade atypical carcinoids [ACs]) and poorly differentiated (high-grade large cell neuroendocrine carcinoma or SCLC). Little is known about EGFR mutation in LCNET although EGFR mutation were frequently found ( about 40% ) in Indonesia NSCLC population.

      Method

      We reviewed 3 cases from our hospital of large cell neuroendocrine tumor ( LCNET) with EGFR mutation testing available. Clinical data and therapeutic responses were retrospectively evaluated.

      Result

      Case#1 was a 53 years heavy smoker male with shortness of breath since 6 months, stg 4 T4N3M1a/pericardial effusion, Trans-thoracal Core biopsy showed LCNEC and harboring EGFR mutation in Exon 18 G719S. He was given Gefitinib, but the diseased progressed within 2 months and continued with Platinum based regimen with survival of 9 months.

      Case#2 was a 64 years old heavy smoker male with shortness of breath and chronic fatigue since 6 months, stg IV T3N3M1a, biopsy from neck lymph nodes showed LCNEC and harboring EGFR mutation in Exon 19 INS/DEL. He was given Erlotinib, but the diseased progressed within 2 months and refused to be given chemotherapy, with survival of 5 months since diagnosis.

      Case#3 was a 48 years old Non Smoker male with shortness of breath and chronic cough since 3 months, stg IIIB T4N3M0, biopsy from supraclavicular lymph nodes showed LCNEC and harboring EGFR mutation in Exon 21 L858R and L861Q. The disease remain stable for 13 months with Erlotinib, and followed by platinum based chemotherapy thereafter. He survived 20 months after diagnosis.

      Conclusion

      De-novo EGFR mutation were found in LCNEC, but the response of the TKI is variable.

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    P1.03 - Biology (ID 161)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.03-44 - Role of Serum Procalcitonin as Diagnostic Biomarker of Pneumonia in Lung Cancer Patient (ID 387)

      09:45 - 18:00  |  Author(s): Andika Chandra Putra

      • Abstract
      • Slides

      Background

      Pneumonia accounts for higher morbidity and mortality than any other infections in lung cancer patients. Procalcitonin (PCT) is a clinical biomarker that widely used to diagnose infection including pneumonia. The cut off level of serum procalcitonin to diagnose pneumonia in lung cancer patient still unclear. The current study aimed to determine the role of PCT in diagnosing pneumonia in lung cancer patients.

      Method

      Diagnostic test with cross sectional design was conducted in lung cancer patients with suspected pneumonia admitted to emergency and pulmonary ward of Persahabatan Hospital Jakarta, Indonesia between August – October 2018. Pneumonia was defined as the presence of new or progressive infiltrate or air bronchograms on chest radiograph with minimal 2 acute signs and symptoms of lower respiratory tract infection. Serum PCT level (sPCT), leucocyte count, and absolute neutrophil count between lung cancer patients with and without pneumonia was measured followed by statistical analysis. The optimal sPCT cut off point to diagnose pneumonia in lung cancer was determined using ROC curve.

      Result

      A total of 60 subjects enrolled in this study. Lung cancer patients presented with pneumonia was found in 31 patients (51.7%) with mean age 54.68±10.59 yo, which 77.4% were males, 51.6% were adenocarcinomas, 83.9% were stage IV cases, 45.2% were patients with ECOG performance status of 3, 45.2% were underweight and 54.8% were ex-smokers. The sPCT were significantly higher in lung cancer patients with pneumonia compared to those without pneumonia [1.81 (0.08-200) μg/L vversus 0.30 (0.05-3.67) μg/L; p<0.001]. In both group showed an elevation of leucocyte count (17.340 cells/μL versus 13.660 cells/μL) and absolute neutrophil count (14.955 cells/μL versus 11.872 cells/μL) with no significant differences (p=0.297 and p=0.290, respectively). The sPCT showed a good accuracy to diagnose pneumonia in lung cancer with AUC 0.829 (CI 95% 0.722-0.935). The optimal cut off point of sPCT to diagnose pneumonia in lung cancer was 0.65 μg/L with 77.4% sensitivity and 79,3% specificity.

      Conclusion

      The sPCT was significantly higher in lung cancer patients with pneumonia than those without pneumonia and showed a better performance in differentiating pneumonia in lung cancer patients compared to leucocyte count and absolute neutrophil count. The optimal cut off level of sPCT to diagnose pneumonia in lung cancer was 0.65 μg/L.

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