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Shi Qiu



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    P1.12 - Small Cell Lung Cancer/NET (ID 179)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.12-14 - Phase II Trial of Apatinib Plus Chemotherapy for Second-Line and Above Treatment of Advanced SCLC: Focus on Efficacy and Safety (Now Available) (ID 1788)

      09:45 - 18:00  |  Author(s): Shi Qiu

      • Abstract
      • Slides

      Background

      Small-cell lung cancer (SCLC), which accounts for 15% of all lung cancers, is characterised by its rapid proliferation. The clinical outcomes of second-line and above treatments are unsatisfactory, resulting in a median progression-free survival (PFS) of less than 3 months. There is currently none targeted drugs or new chemotherapeutic drugs that can achieve breakthroughs in advanced SCLC. This study aims to observe whether apatinib in combination with chemotherapy can be a new choice for second-line and above treatment of advanced SCLC.

      Method

      This is a prospective, single-center, single-arm clinical study designed to evaluate the efficacy and safety of apatinib plus chemotherapy for second-line and above treatment of advanced SCLC (ClinicalTrials.gov NCT03547804). Patients received 500mg apatinib qd orally, if the patient has a grade 3/4 adverse reaction during the treatment, it can be reduced to apatinib 250mg qd orally. Chemotherapeutic agents are limited to irinotecan or docetaxel alone. The primary endpoint was the progression-free survival (PFS). The secondary endpoints included overall survival (OS), disease control rate (DCR), objective response rate (ORR), and adverse events (AEs).

      Result

      Twenty patients were enrolled from March 2018 to March 2019. Fifteen patients were available for response evaluation. The ORR and DCR were 33.33% (5/15) and 93.33% (14/15), respectively. The predicted median PFS time was 5.8 months (95% confidence interval [CI] 5.1-6.5 months) (SPSS 20.0 software). The most common treatment-related AEs were neutropenia (45.0%), leucopenia(35.0%), abnormal liver function (20%), nausea and vomiting (20%) and thrombocytopenia (20.0%), without any treatment-related deaths. It is worth noting, 12 patients underwent apatinib reduction due to grade 3/4 adverse reactions.

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      Conclusion

      Apatinib plus single agent chemotherapy showed promising efficacy in a patients with advanced SCLC who had failed chemotherapy. And the recommended phase II dose of apatinib as combination therapy was 250 mg qd.

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    P2.03 - Biology (ID 162)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.03-46 - PI3K/AKT Signal Pathway Regulates Malignant Transformation of MPLC with EGFR-Sensitive Mutation (Now Available) (ID 2456)

      10:15 - 18:15  |  Author(s): Shi Qiu

      • Abstract
      • Slides

      Background

      Multiple primary lung cancer (MPLC) is a presumed uncommon entity, but its true incidence, ranging from 0.2% to 8%, is increasing as the result of the widespread use of early detection tools. MPLC displays diverse clinical trajectories and genomic profiles. The in-depth study on the mechanism of malignant transformation of MPLC will provide new ideas for the future treatment of MPLC.

      Method

      In this study, we analyse the genomic profiles of 25 tumors and 12 adjacent tissues from 10 patients with MPLC who underwent surgical resection through the whole-exome sequencing (WES).

      Result

      Ten patients were enrolled in this study, one patient with different evolutional stages of the same disease (AAH, MIA, and IA) and one patient with completely different pathologies (adenocarcinoma and squamous cancer). Eight patients with different driver genes (EGFR exon 19 deletionexon 21 L858R mutation and exon 21 L861Q mutation) of lung adenocarcinoma. We observed different mutational landscapes between tumors in the same patient by analyzing somatic mutations, copy number variations, clonal structures, and signal transduction pathways. Most tumors showed significant APOBEC mutant patterns, especially C→T transversions (Figure 1). Moreover, we also found that EGFR exon 19 and 21 mutations enrich different signal pathways. The PI3K/AKT signal pathway is often be enriched in tumors with EGFR exon 19 deletion, which is closely related to the early progression of the tumor. While PTEN kinase activation is associated with EGFR exon 21 L858R mutation (Figure 2). MPLCs with EGFR wild-type may be associated with abnormal regulation of signal pathways, including SOS1, JAK-STAT and others.

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      Conclusion

      This study suggests that the different "gene mutation trajectories" of EGFR exon 19 and 21 mutations are closely related to the genetic heterogeneity of MPLC. Besides thatAPOBEC mediated mutations may play an important role in the initial malignant transformation of tumors.

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