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Ning Wu
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JCSE01 - Joint IASLC-CSCO-CAALC Session (ID 63)
- Event: WCLC 2019
- Type: Joint IASLC-CSCO-CAALC Session
- Track:
- Presentations: 1
- Now Available
- Moderators:Chunxue Bai, Tony Mok, Yi-Long Wu, Qing Zhou, Nan Wu
- Coordinates: 9/07/2019, 07:00 - 11:15, Toronto (1985)
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JCSE01.10 - Efficacy and Safety of Neoadjuvant PD-1 Blockade with Sintilimab in Resectable Non-Small Cell Lung Cancer (Now Available) (ID 3424)
07:00 - 11:15 | Author(s): Ning Wu
- Abstract
- Presentation
Abstract
Background
NSCLC patients who have potentially resectable disease often subsequently relapse after surgery. New therapy that prevents relapse after surgery is desperately needed. In this study, we tested the efficacy and safety of neoadjuvant sintilimab, an anti-PD-1 antibody, for patients with resectable sqNSCLC in China.
Methods
All patients had treatment-naïve resectable sqNSCLC (stage IB-IIIA) that was confirmed by histopathology. Patients received two cycles of sintilimab (200 mg IV) on Day 1 and 22. Surgery was performed between Day 29-43. An enhanced PET/CT was obtained at baseline and seven days prior to surgery. Preliminary analysis of safety profile and efficacy was planned after at least 20 patients had received operation.
Results
As of Jan. 28, 2019, 22 patients (20 males and 2 females) with sqNSCLC received two doses of sintilimab followed by radical resection. The median age was 61.5 yr (range, 48 to 70). Six (27.3%) and four (18.2%) patients experienced neoadjuvant treatment emergent adverse events (TEAEs) and neoadjuvant treatment-related AEs (TRAEs), respectively. Most of the TEAEs and TRAEs were grade 1 or 2. Three patients achieved radiological partial response: an ORR of 13.6% based on RECIST 1.1. Ten patients (45.5%) achieved a major pathologic response (MPR, ≤10% viable tumor cells), including four (18.2%) had complete pathologic response (no viable tumor cell). There was a direct correlation between pathological response and decrease in the standardized uptake values (SUV) in the primary tumor. Among nine patients with > 30% decrease of SUV, eight had MPR, compared with no MRP response in the 11 patients with ≤30% decrease of SUV.
Conclusion
Neoadjuvant sintilimab for sqNSCLC patients was tolerable and the 45.5% MRP rate is encouraging. A decrease in SUV may be predictive of pathologic response after PD-1 therapy in sqNSCLC.Only 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, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P1.11 - Screening and Early Detection (ID 177)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.11-39 - Low-Dose CT Lung Screening: Data Analysis of Lung Cancer Patients with Above 40 Years Old (ID 2139)
09:45 - 18:00 | Author(s): Ning Wu
- Abstract
Background
LDCT lung cancer screening now being implemented in US and some European countries. However, LDCT lung cancer screening is still under consideration in China due to the epidemiological characteristics, medical system and patient compliance. This study aims of 1) to explore the application value of LDCT lung cancer screening in different age groups in China through analysis the data of clinical, pathology and radiology for LDCT participants, 2) to improve the effectiveness of LDCT lung cancer screening.
Method
10033 participants had LDCT lung cancer screening in Cancer Hospital, Chinese Academy of Medical Sciences were involved and divided into three groups by age (40-49, 50-59 and ≥ 60years old group). The detection rate was calculated for overall and individual groups. Clinical, pathology and radiology data were also collected and analyzed for group differences.
Result
Lung cancer detection rate: The overall lung cancer detection rate with LDCT was 0.6% (64 cases) and the detection rate for 40-49, 50-59 and ≥60 years old group was 0.4%, 0.6%, 1.2% respectively. The difference of lung cancer detection rate between age groups was significant (P=0.001), and increased with age (P=0.002).
Stage: In 64 lung cancer cases, the proportion of stage I, II, III, IV were 88%,5%, 5%, 2% respectively, with more advanced lung cancers (stage III or IV) were oberserved in ≥60 years old group than other groups(P=0.031).
Pathological type: Adenocarcinoma was 61 cases (61/64, 95.3%), and squamous-cell carcinoma, small cell carcinoma and carcinoid was 1 case respectively, no significant differences of pathological types were found among three groups (P=0.134).
Tumor markers: 9 cases had CEA increase (9/53,17.0%), among which 7 cases were in ≥60 years old group (7/24, 29.2%), higher than other age groups, and the difference was statistically significant (P=0.03). In addition, The odds ratio of CEA abnormally increased in ≥60 years old group was 2.059 (95% CI:0.36-11.91) compared with the 40-49 years old group.
Other clinical parameters for all age groups showed no significant difference (P>0.05).
Conclusion
The LDCT lung cancer detection rate increased significantly with age.
40-49years old group detection rate is lower than overall. ≥60years old group had the highest detection rate but stage III or IV patients proportion rised. Thus, we recommended it LDCT lung cancer screening for ≥50 years old to guarantee more early stage lung cancer cases being detected.
LDCT lung cancer screening for ≥60years old could combine with CEA.
This study detected 88% stage I lung cancers.
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-37 - Low-Dose CT Lung Screening: Analysis of Risk Factors Related to Lung Cancer (ID 2283)
10:15 - 18:15 | Author(s): Ning Wu
- Abstract
Background
LDCT has been increasingly accepted as an efficient screening method for lung cancer detection and mortality reduction in high-risk populations. Screening data based lung cacer risk factors analysis is supposed to benefit identifying high-risk population of lung cancer.The aims of this study are to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening.
Method
Subjects consisted of 5366 asymptomatic and voluntary participants (includes 2762 males and 2604 females) aged 40-87 years old, who received LDCT in Cancer Hospital, Chinese Academy of Medical Sciences between Jan 1st, 2014 and Dec 31st, 2017.
Result
Participants finished questionnaires relevant to risk factors and were provided Low-dose CT scans. The LDCT Radiological results were interpreted according to the I-ELCAP lung Screening Protocol.
Multivariate logistic regression examined associations of risk factors within Age, Sex, Smoking status, Second-hand smoking status, COPD, Asthma, Family history of lung cancer, History of tuberculosis, Occupational exposure and Diabetes.
389 of the 5366 participants had a positive(including lung cancer) screen with LDCT, 26 participants were pathologically confirmed lung cancer. Multivariate logistic regression showed that age and smoking (previous smoking and current smoking) were risk factors related to lung cancer and positive nodules. There was no risk factor in distinguishing between lung cancer and positive nodules(excluded lung cancer). Stratified by age, Multivariate logistic regression did not identify any risk factor related to lung cancer and positive nodules in 40-49 years old group, while 3 risk factors were identified in ≥50 years old group (age, smoking, and history of tuberculosis).
Conclusion
• Age, smoking are risk factors related to lung cancer and positive nodules.
• ≥50 years old with a history of smoking or tuberculosis may be a high risk group for lung cancer in China.
