Virtual Library
Start Your Search
Tindara Franchina
Author of
-
+
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
-
+
P1.04-45 - Immune-Oncology Gene Expression Profiles Allow Lung Cancer Patients’ Stratification and Identification of Responders to Immunotherapy (ID 2339)
09:45 - 18:00 | Author(s): Tindara Franchina
- Abstract
Background
Immune-checkpoint inhibitors (ICI) represent a new standard of care for Non-Small Cell Lung Cancer (NSCLC) patients. Beyond tumor PD-L1 protein expression, other biological parameters are emerging as potential predictive biomarkers. We evaluated high-throughput immune-related Gene Expression Profiles (GEP) in tumor tissue from ICI-treated patients, correlating immune activation data with clinical response to immunotherapy.
Method
RNA was isolated from tumor tissues of 44 metastatic NSCLC patients treated with Nivolumab (as 2nd or 3rd line therapy) and collected from different Italian centers. The nCounter® PanCancer IO360™ Panel was applied on NanoString platform to analyze 770 genes involved in key immuno-oncology pathways. Clinical-pathological data, as well as best response to ICI treatment, have been collected.
Result
Patients were dichotomized as responders (7 Partial Response and 19 Stable Disease) and non-responders (18 Progressive Disease). A pre-identified T-cell inflamed signature was evaluated at single gene level and the expression of CCL5, CD27, CD276, CMKLR1, CXCL9, CXCR6, LAG3, NKG7, PDCD1LG2, PSMB10, TIGIT was higher in the responder group, although not reaching statistical significance. Moreover, higher STING, CGAS and IRF3 genes expression level appeared to be more commonly associated with non-responder patients.
Considering the disease stage at the time of diagnosis, a different gene panel (CCL5, CD27, CD274, CD8A, CXCL9, CXCR6, HLA-DQA1, HLA-DRB1, HLA-E, IDO1, LAG3, NKG7, PSMB10, TIGIT) resulted to be more expressed in early and locally advanced (16 from stage I to IIIA) compared to metastatic (28 stage IV) tissue samples.
Conclusion
A trend in differential expression patterns was observed between responders and non-responders NSCLC patients treated with Nivolumab and additional analyses on this cohort could reveal specific pathways able to predict unresponsiveness to ICI treatment. Different disease stage seems also to influence immune-related GEPs.
-
+
P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.16-38 - Efficacy and Safety of Target Therapy and Immunotherapy in Advanced NSCLC in Elderly: A Systematic Review of Real World Studies (ID 2757)
10:15 - 18:15 | Presenting Author(s): Tindara Franchina
- Abstract
Background
Despite notable advances, treatment of advanced non small cell lung cancer (NSCLC) in the elderly remains a challenge.Target therapy and immunotherapy outcomes have been demonstrated in several randomized controlled trials (RCT), however real world setting may closely mirrors everyday clinical practice in elderly population, characterized by poor performance status, significant comorbidities, concomitant treatments, limited adherence and compliance. Systematic review was conducted to examine the published real-world studies evaluating efficacy and safety of target therapy and immunotherapy in elderly patients with advanced NSCLC. These real-world data were compared to those obtained in the phase II and III randomized controlled trials.
Method
Following PRISMA guidelines, in February 2019 we searched the MEDLINE, Web of Science, and Scopus databases in English language.Titles and abstracts were reviewed by 2 independent reviewers (FT; FV); disagreements were resolved by a third. All identified full papers were assessed independently by three researchers (FT, FV, and AV). Included studies were required to be RWS, and evaluate target therapy or immunotherapy in advanced NSCLC elderly patients. The Newcastle Ottawa Scale (NOS) was used for quality assessment of studies included in the systematic review.
Result
We found 235 studies through the database, 167 remained after duplicate removal and 24 full-text articles were assessed for eligibility (Figure 1). The systematic search of the literature identified 9 studies meeting the selection criteria to analyse in qualitative synthesis.These studies included a total of 1882 elderly patients mainly treated with first-generation EGFR tyrosine-kinase inhibitors (5 studies), osimertinib only in one study. Bevacizumab in association with chemotherapy was evaluated in two studied. Immunotherapy data was available only in one study. Clinical characteristics of each study population are analyzed. The first relevant aspect is the lack of data on Multidimensional Geriatric Assessment and Charlson Comorbidity Index, that should represent main instruments in clinical practice to personalize therapeutic approach. Heterogeneity of first-generation EGFR TKI efficacy among the studies could be influenced by genetic differences among ethnic groups. In general, the results showed that PFS of patients with advanced NSCLC treated with first-generation EGFR TKI in the real world setting were consistent with those observed in clinical trials, while an inferior survival was recorded. Collected toxicity data were limited.
Conclusion
RWS represent a broad picture of the activity and tolerability of new drugs and can provide interesting observations and research ideas in several settings, particularly in elderly patients, integrating and defining data of the RCTs.
