Virtual Library

Start Your Search

Luis Eduardo Pino



Author of

  • +

    EP1.03 - Biology (ID 193)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
    • +

      EP1.03-02 - Frequency of Microsatellite Instability in Patients with Primary Non Small Lung Cancer in a Single Institution from Colombia (Now Available) (ID 322)

      08:00 - 18:00  |  Presenting Author(s): Luis Eduardo Pino

      • Abstract
      • Slides

      Background

      Lung carcinogenesis is a focus of research for prognosis and development of possible therapeutic objectives. The microsatellite instability (MSI) has been described as a potential mechanism of cancer development mainly in colorectal cancer as a marker of prognosis and treatment response. In lung cancer is not known the precise frequency of MSI and its possible implications for precision therapeutics. Past trials reported a low incidence of this biological signature, but this finding could improve some immune characterization of lung cancer focused in immunotherapeutics. Is very important to know the incidence of MSI in lung cancer in a sample of latin patients to know its indicence y relation with some clinical features.

      Method

      The present study is a case series were we describe microsatellite instability (MSI) in patients with primary non small cell lung cancer. First, the patients with non-small cell lung carcinomas of the Hospital Militar Central diagnosed between january 2010 and january 2016 were included, then the clinical charts of each patient were reviewed to identify clinical and socio-demographic variables. The immunohistochemical staining were realized in the paraffin blocks using the Ventana Benchmark Ultra and GX equipment allowing the identification of the mismatch repair proteins (MMRP) MLH1, PMS2, MSH2 y MSH6; defining microsatellite instability with the negativity for any of these markers. We reviewed other molecular biology signatures : EGFR mutation and KRAS in some cases were this finding could be avaliable. In Colombia there´s no health system coverage for this mutations.

      Result

      33 patients with non-small cell lung carcinoma were included in the study. Of this patients we can identify 69.7% with lung adenocarcinoma and 30.3% with squamous cell lung carcinoma. 54.5% of the total of patients were diagnosed in stage IV (TNM 7th edition). We identified a history of tobacco exposition in 45.5% of this patients. In the immunohistochemical staining, we identify that 9.1% of all the patients had microsatellite instability (MSI high); with negativity for the expression for MHL1 gene in 2 patients and for MSH6 gene in 3 patients, all of this patients were diagnosed with lung adenocarcinoma and all of this patients were EGFR wild type, in 1 of this patients we found a registry of KRAS mutated tumor. For the MHL1-negative patients, one of them had tobacco exposition history (heavy smoker) and for the MSH6-negative patients 2 of 3 had a tobacco exposition history. Unfortunately we didn´t found any of this patients treated with immunooncology agents.

      Conclusion

      In a small latin population at a single institution the present study found a frequency of 9.1% in 33 patients with non-small cell lung cancer with microsatellite instability (MSI-High). All of this patients were adenocarcinoma subtype, non related with EGFR mutations and with a correlation with tobacco exposure. Unfortunately this is a small case series and we could not establish a response to immunooncology agents because in Colombia we have this medications available since 2018. The frequency of this finding is higher than previous reports and must be confirmed in a multiinstitutional registry from latin population in development.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    EP1.04 - Immuno-oncology (ID 194)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
    • +

      EP1.04-46 - Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP) (Now Available) (ID 2776)

      08:00 - 18:00  |  Author(s): Luis Eduardo Pino

      • Abstract
      • Slides

      Background

      Immunotherapy for NSCLMC offers a significant advantage to chemotherapy in selected cases. This benefit starts to disapear as the patients start two progress and requiere change in medication or even chemotherapy. The objective of this study was to compare survival outcomes of patients with advanced or metastatic NSCLC who received immunotherapy at first, second or beyond versus matched patients receiving standard chemotherapy.

      Method

      A retrospective multicenter international cohort study of 296 patients with unresectable/ metastatic NSCLC treated with immunotherapy either as first, second, third or fourth line was conducted. A matched comparison with a historical cohort of first line chemotherapy was conducted.

      Result

      Median age was 64 years (Range 34-90) and 40.2% were female patients. 91.2% of patients had an ECOG performance score ≤ 1. Immunotherapy as first line was given to 39 patients (13.7%), second line to 140 (48.8%), and as third line and beyond to 108 (37.6%). Median overall survival was 19.9 months (95% CI 14.5-22.7 months) and progression-free survival was 3.73 months (95% CI 2.8-4.2). Factors associated with increased survival included treatment as first-line (p < 0.001), type of response (p < 0.001) and PD-L1 status (p = 0.0039). Compared with the historical cohort, immunotherapy proved to be superior in terms of OS (p= 0.05) but not PFS (p= 0.2).

      Conclusion

      Patients who receive immune checkpoint inhibitors as part of their treatment for NSCLC have better OS compared with matched patients treated with standard chemotherapy, regardless of treatment line.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    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
    • +

      P1.04-81 - Characterization of Hispanic Patients Who Experienced Hyperprogression During Treatment for Advanced NSCLC with Immunotherapy (ID 2922)

      09:45 - 18:00  |  Author(s): Luis Eduardo Pino

      • Abstract

      Background

      Immunotherapy related hyperprogression is poorly characterized in Latin American patients. In this study we sought to characterize and identify factors associated with the presentation of hyperporgression after initiation of immunotherapy in patients with advanced non-small cell lung cancer (NSCLC).

      Method

      A multicenter international retrospective study on 110 patients was conducted. Clinical variables as well as routine blood studies were recorded before initiation of treatment. Regression analysis was used to find associations. A random forest tree analysis (RFTA) based on continuous and discrete variables was used to subcategorize patients based on occurrence of hyperprogression.

      Result

      Median age was 64 years (Range 34-90) and 59.8 % were male patients. ECOG performance status was >1 on 8.8% of patients. Median overall survival was 12.7 months (95% CI 9.67-14 months) and progression-free survival of 4.27 months (95% CI 3.97-5.0). 44 hyperprogressors were documented (19.8%, [95%CI 14.5-25.1%]). Median time to progression was approximately 5 weeks after initiation of treatment. Factors associated included albumin and hemoglobin levels (p = 0.046 and 0.037 respectively), presence of CNS (p= 0.0009) and bone metastasis (p = 0.004) and weight loss (p= 0.004). RFTA revealed that a leucocyte count over 5.300 cells/dl was present in all hyperprogressors.

      Conclusion

      Hyperprogression is a phenomenon after initiation of immunotherapy which is associated with clinical and paraclinical variables. These associations could be used to withhold certain agents and prevent its occurrence in NSCLC treatment.

  • +

    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
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
    • +

      P2.16-22 - Predictive Analytic of Survival Using a Neural Network in a Real World Cohort of Advanced Non Small Cell Lung Cancer Patients (Now Available) (ID 2291)

      10:15 - 18:15  |  Presenting Author(s): Luis Eduardo Pino

      • Abstract
      • Slides

      Background

      When talking about a probabilistic neural network a new concept on survival is introduced. Using advanced statistics, different characteristics amongst patients such as oncogenic driver mutation, smoking status or age can be correlated to calculate the probability of survival in each individual and even for each attending institution.

      Method

      We built a neural network model that allowed us to estimate the probability of mortality according to the variables: Oncogenic addiction (EGFR mutation and ALK rearrangements), expression of PDL-1, age, gender and exposure to cigarette. These variables were obtained from a cohort of patients with advanced non-small cell lung carcinoma who received treatment in our institution during the last 3 years.

      Result

      Thirty-one patients were included in the model. The accuracy of the neural network was 78.57% for the patients that died and 82.35% for the patients still alive. It was possible to calculate the probability of overall survival and the probability of dying in relation to age, exposure to cigarette, gender, oncogenic addiction and PDL-1 expression for each person and for the whole cohort. Individual results and global results (Kaplan Meier) are shown in table and graphic.

      results neural network.jpgsurvival kaplan meier.png

      Conclusion

      The minimum data sample required to produce the model was used (n=31), thus it would not be correct to talk about global conclusions. However, this is a representative model of a proof of concept related to predictive analytics related to probability of survival in a real world setting using a neural network that worked on an individual basis according to clinical and biological characteristics. Results for the entire cohort are also available. Using a greater amount of data will increase the accuracy of the neural network to predict survival and other outcomes in an individual and even institutional basis that will improve data analytics in real oncologic settings.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.