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Inês Guerreiro



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    P2.09 - Pathology (ID 174)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Pathology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.09-22 - Molecular and Immunological Profiles of Lung Carcinoma: Are They Associated? (ID 2673)

      10:15 - 18:15  |  Author(s): Inês Guerreiro

      • Abstract
      • Slides

      Background

      Lung cancer, usually related to tobacco and other exposures, has also risk factors that suggest a genetic susceptibility. Thus, there has been increasing interest in the definition of oncogenic changes that allow targeted therapy. On the other hand, immunological checkpoint inhibitors have been shown to be increasingly effective, regardless tumor histology or expression of PD-L1. We aimed to characterize the presence of predictive response mutations to target therapies and the immunological profile of non-small cell lung cancer (NSCLC), and to study possible associations between them.

      Method

      Retrospective study of NSCLC cases submitted to the determination of PD-L1 by the Pathology Service since January 2017 until March 2019 and, in those patients, description of the predictive response mutations in the EGFR, ALK and ROS1 genes. Data were analyzed using simple descriptive statistics methods. To test hypotheses, we used the chi-square test, and the predictive factor search was performed through logistic regression.

      Result

      A total of 794 patients were identified, 73.8% male (n=586), with a median age of 67 years (IQR, 13). The histological type was classified as adenocarcinoma in 69.3% of cases (n=550) and squamous cell carcinoma in 22.8% (n=181). Among the adenocarcinomas, we found predictive mutations in the EGFR gene in 17.6% of the patients (n=97), translocation in the ALK gene in 4.9% (n=27), and rearrangement in the ROS1 gene in 0.9% (n=5). PD-L1 expression was positive in 54.2% of the cases (n=430), and superior to 50% in 22.9% (n=182). Overall, the association between PD-L1 expression and EGFR status was not statistically significant. However, there was an association between PD-L1 expression and EGFR mutation in females (p=0.013). There was also an overall association between PD-L1 expression and ALK translocation (p<0.001), and this association was maintained in the gender analysis for the male patient group (p=0.003). In the multivariate analysis, the ALK translocation was a predictor of PD-L1 expression.

      Conclusion

      The molecular profile of lung carcinoma was similiar to what is described in the literature. In our study, there was a statistically significant association between ALK translocation and PD-L1 expression in the global population. It would be interesting to understand the biological behavior of this group of tumors and, in the future, to study the role of eventual therapeutic associations.

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