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J. Luis Mate Sanz



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    EP1.04 - Immuno-oncology (ID 194)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.04-25 - Increased PD-L1 Expression in MET Amplified (AMP) Advanced Non Small Cell Lung Cancer (NSCLC) Patients (P) (ID 2764)

      08:00 - 18:00  |  Author(s): J. Luis Mate Sanz

      • Abstract
      • Slides

      Background

      MET amp has been reported in a subset of NSCLC p and treatment with crizotinib has proved clinical activity in cases of MET exon 14 alterations and MET amp.. Recently, immunotherapy has emerged as a new approach to treat NSCLC. The development and success of programmed cell death 1 (PD-1)/program death-ligand 1 (PD-L1) checkpoint inhibitors has been correlated with PD-L1 status, particularly in NSCLC p whose tumors express high PD-L1 levels by tumor proportion score (TPS) ⩾ 50%. In this study we have reviewed the PD-L1 status in a cohort of advanced NSCLC p with a METamp.

      Method

      PDL1 expression has been evaluated in a retrospective cohort of NSCLC p with MET amp and wild type for EGFR, KRAS, BRAF mutations and ALK and ROS1 rearrangements. Overall Survival (OS) was evaluated with Kaplan-Meier curves and groups were compared using log-rank test. Clinical and tumor characteristics, as well as treatment details, were evaluated. MET amp was analyzed by FISH, while PD-L1 status was assessed by immunochemistry by SP 263. antiboby

      Result

      A total of 50 p were included, 15 p has high or intermediate Met amp and 35 p had low or negative Met amp. Median age were 66 years old. 39 (78%) p were male, 43 (86%) p were smokers or former smokers, 37 p (74%) were ECOG PS 0-1, 37 p (74%) were stage IV. PD-L1 were negative ( < 1%) in 21 p (42%), positive ( >1%) in 26 p ( 52%). PD-L1 highly positive in 18 p ( 36%). Statistically significant more p had PD-L1 positive ( TPS > 1%) in high or intermediate Met amp p versus low or negative ( 92.9% vs 39.4%; p 0.001). And high or intermediate Met amp p had PD-L1 high expression ( TPS > 50%) than negative or low Met amp p ( 64.3% vs 27.3%; p 0.020). No differences in PD-L1 expression was observed by gender, ECOG PS or smoking status. Median OS was 16.367 m (2.295-30.438). No differences in OS were seen by PD-L1 expression or Met amp status.

      Conclusion

      PD-L1 expression in NSCLC p is positively correlated with MET amp, especially in p with PD-L1 > 50%. Our data suggests that MET amp may play a direct role in up-regulating PD-L1 expression in NSCLC p. Additionally, combination therapy targeting MET and checkpoint inhibition should be considered as a potential therapeutic strategy for NSCLC p with high and intemediate MET amp.

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    P2.05 - Interventional Diagnostic/Pulmonology (ID 168)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Interventional Diagnostics/Pulmonology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.05-15 - Radial Endobronchial Ultrasound-Guided Transbronchial Biopsy in Peripheral Lung Lesions. What Can Cryobiopsy Contribute? (Now Available) (ID 865)

      10:15 - 18:15  |  Author(s): J. Luis Mate Sanz

      • Abstract
      • Slides

      Background

      Radial probe endobronchial ultrasound (RP-EBUS) is a modern technique for diagnosis of peripheral lung lesions. The addition of transbronchial cryobiopsy (TBCB) could increase the diagnostic value for RP-EBUS. AIM: To evaluate the efficacy of RP-EBUS guided TBCB for diagnosis of peripheral lung lesions.

      Method

      We collected 60 patients with peripheral lung diseases. Were excluded 15 patients for not be fit for general anesthesia (necessary for TBCB) or high risk of bleeding. 45 patients were subjected to forceps transbronchial biopsy (forceps TBB) and TBCB guided by RP-EBUS. The diagnostic outcomes including digital assessment for qualitative and quantitative measures of collected samples were detected. Also, the associated complications were recorded.

      Result

      The diagnostic yields for forceps TBB versus TBCB is detailed in Table 1. TBCB has achieved higher accuracy than forceps TBB (ROC area of 0.88 versus 0.84 respectively), with no statistical difference between their values (p=0.32). The combination between both techniques has achieved excellent accuracy (ROC area 0.91). In 36 cases were possible the anatomopathological diagnosis with both type of samples, there were significant statistical differences (p ≤ 0.05) in favour of TBCB when compared to forcep TBB regarding; mean biopsy diameter, mean biopsy surface area, mean biopsy necrosis, percentage and mean biopsy viable tissue area. Only two patients had significant complications (pneumothorax; hypoxemia), and 8 moderate bleeding.

      tabla crio lcc.jpg

      Conclusion

      Conclusions: RP-EBUS guided TBCB is a safe and effective technique for diagnosis of peripheral lung lesions. TBCB could achieve higher diagnostic value than forceps TBB due to better quantity and quality of the samples.

      The project was partially funded by SEPAR, grant AEER 2016, grant FUCAP 2017 and Egyptian Ministry of Higher Education.

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