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Chenlei Zhang
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EP1.14 - Targeted Therapy (ID 204)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.14-13 - EGFR Mutation in Lung Adenocarcinoma: Real World Study from a Single Institute (ID 2537)
08:00 - 18:00 | Author(s): Chenlei Zhang
- Abstract
Background
To investigate the EGFR mutation in lung adenocarcinoma of real world.
Method
Patients diagnosed lung adenocarcinoma and performed EGFR mutation analysis in Liaoning Cancer Hospital & Institute from June 2014 to April 2018 were collected retrospectively. Gender, age, EGFR mutation status of patients were analyzed.
Result
There were 779 patients included in the study. Of all patients, 365 were male, 414 were female, median age was 60 years-old (range 29-80). EGFR mutation analysis showed that there were 417 mutation cases, 362 were negative, the overall mutation rate was 53.5%. For male patients, the mutation rate was 37.0% (135/365), and 68.1% for female patients (282/414). Seven hundred and sixty-one patients had one EGFR mutation type, 17 had two types, and 1 had three types. The most common type of EGFR mutation was Exon 21 L858R (204/436, 46.8%), and the second common was Exon 19 deletion (175/436, 40.4%), other mutation types were significantly less, including Exon 20 insertion (20/436, 4.6%), Exon 18 G719X (19/436, 4.4%), Exon 20 S768I (10/436, 2.3%), Exon 21 L861Q (5/436, 1.1%). Primary resistance of T790M mutation were found in 3 patients (0.7%), however, all the 3 cases had two types of mutations besides T790M mutation (2 Exon 19 deletion and 1 Exon 21 L858R).
Conclusion
The overall EGFR mutation rate was over 50% in our institution, and higher in female patients, about 70%. The most common mutations were Exon 21 L858R and Exon 19 deletion, and other mutation types were rare. Finally, T790M mutation often combined with the other type of EGFR mutations.
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EP1.18 - Treatment of Locoregional Disease - NSCLC (ID 208)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.18-20 - Sleeve Lobectomy for Centrally Located Non-Small Cell Lung Cancer: Initial Short-Term Results from a Single Institute in Northeast China (Now Available) (ID 986)
08:00 - 18:00 | Author(s): Chenlei Zhang
- Abstract
Background
To evaluate the feasibility and short-term outcome of sleeve lobectomy for centrally located non-small cell lung cancer in Northeast China.
Method
Clinical data of 69 patients who underwent sleeve lobectomy in the Department of Thoracic Surgery of Liaoning Cancer Hospital & Institute from November 2016 to February 2019, were retrospectively collected. Operative strategies, duration of postoperative drainage, postoperative hospital stay, complications and follow-up data were recorded. Simple bronchoplasty or angioplasty without any sleeve resection was excluded in this study.
Result
14 of the 69 patients received neoadjuvant chemotherapy because of N2 disease. Nine underwent bronchial and arterial sleeve lobectomy (double sleeve resection), 6 bronchial sleeve resection and partial resection of pulmonary arterial wall (angioplasty), 2 arterial sleeve resection and partial resection of bronchial wall (bronchoplasty), 2 arterial sleeve resection only, 50 bronchial sleeve resection only., Simple sleeve resection was achieved in 57 cases, and extended sleeve resection in 12 cases. Of the extended cases, two were classified as Okada type B, 2 Okada type C, 5 Okada type D, 2 with complex anastomosis between left main stem bronchus with superior and basal bronchus, 1 with anastomosis between trachea and right middle lobe bronchus . There was 1 perioperative death (1.4%), which was highly suspected of myocardial infarction. There was neither anastomotic fistula nor symptomatic stricture, which needed treatment thereof. Surgical margin status was R0 in 50 patients (72.5%), R1 in 18 patients (26.1%), and R2 in 1 patient (1.5%). The median time of postoperative drainage was 7 days (3-33 days), median time of postoperative hospital stay was 11 days (6-39 days). Major complications occurred in 14 patients (21.5%), including 2 with chylothorax, 7 pneumonia, 3 pleural effusion, 1 air leak, 1 heart failure. Atelectasis necessitated endoscopic sputum clearance in 16 patients. Pathology showed squamous cell carcinoma in 50 patients, adenocarcinoma in 16, adenosquamous carcinoma in 2, and large cell carcinoma in 1 patient. Two patients were in stage ⅠA2, 2 in stage ⅠA3, 12 stage ⅠB, 2 stage ⅡA, 34 stage ⅡB, 12 stage ⅢA，and 5 stage ⅢB. The median follow-up duration was 14 months (0-25months), with the follow-up rate of 97.1%. All patients are alive except for one death. The local-recurrent rate was 1.4% (1/69), and the distant metastasis rate was 7.2% (5/69).
Conclusion
Sleeve lobectomy is a safe and reasonable procedure for surgical treatment of centrally located non-small-cell lung cancer. It has the advantages of expanding operation indication, avoiding pneumonectomy, preserving more pulmonary function, and improving postoperative quality of life.
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P1.17 - Treatment of Early Stage/Localized Disease (ID 188)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.17-20 - Evaluation of Efficacy and Safety of Uniportal Segmentectomy in the Treatment of Lung Cancer (ID 1103)
09:45 - 18:00 | Presenting Author(s): Chenlei Zhang
- Abstract
Background
Uniportal segmentectomy is a therapeutic option for early stage lung cancer, but the debate over uniportal segmentectomy still remains. The aim of this study is to evaluate of efficacy and safety of uniportal segmentectomy in the treatment of lung cancer.
Method
A total of 137 patients who underwent uniportal segmentectomy or subsegmentectomy between January 2017 and April 2019 in Liaoning Cancer Hospital. The clinical data of these patients were retrospectively analyzed, including operation time, number of lymph nodes dissected and postoperative mortality, postoperative complications, postoperative intubation time, and postoperative hospital stay.
Result
The surgery procedure was anatomical pulmonary segmentectomy or subsegmentectomy. Uniportal segmentectomy was in 133 cases, and subsegmentectomy was in 4 cases. The median operation time was 243 minutes (range, 60-405 minutes), median number of lymph nodes dissected was 14 (range, 0-31), median drainage time was 5 days (range, 1-9 days), median postoperative hospital stay was 8 days (range, 3-19 days). The postoperative complications were pneumonia 2 case (1.5%), fever 12 cases (8.8%), hemoptysis 1 case (0.7%), air leak 2 case (1.5%), atrial fibrillation 1 case (0.7%), and subcutaneous hydrops 2 cases (1.5%). There was no severe postoperative complications, including death, bleeding, reoperation, and bronchopleural fistula.
Conclusion
Uniportal segmentectomy is a safe and feasible technique for treating early stage lung cancer, with acceptable postoperative complications and mortality.
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P2.14 - Targeted Therapy (ID 183)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.14-06 - The Study of Rac3 Molecular Mechanism Through ERK Signaling Pathway in Lung Adenocarcinoma (ID 1252)
10:15 - 18:15 | Author(s): Chenlei Zhang
- Abstract
Background
To find out the relationship between Rac3 gene and prognosis of lung adenocarcinoma, the role of Rac3 in the proliferation and migration of lung adenocarcinoma cells, and the mechanism of Rac3 promoting the proliferation and migration of lung adenocarcinoma cells.
Method
542 patients with lung adenocarcinoma in the TCGA database were selected for analysis, the expression of Rac3 in cancer tissues and normal lung tissues were compared. Kaplan-Meier Plotter database was selected to analyze the relationship between Rac3 expression and 5-year overall survival rate of patients by Kaplan-Meier method. Human lung adenocarcinoma cell lines A549 and H1299 were used to build Rac3 knockdown and high-expression cell lines. The role of Rac3 in the proliferation and migration of lung adenocarcinoma cells was detected by cell proliferation and healing-wound test. The Rac3 knockdown cell lines were used to detect the changes of intracellular signaling pathways by serum starvation test and Western Blot experiment, screening out the signaling pathways with significant differences and study the biological function of them.
Result
The results of TCGA database analysis showed that Rac3 expression in 542 patients with lung adenocarcinoma was significantly higher than that in normal lung tissues, and the result is statistically significant (P<0.01). Kaplan-Meier survival analysis showed that patients with high Rac3 expression had a significantly shorter 5-year overall survival than those with low Rac3 expression (P<0.0001). In A549 and H1299 cell lines, Rac3 shRNA is used to build Rac3 knockdown and high expression cell lines by lentivirus infection. The proliferation and migration of lung adenocarcinoma cells were detected by cell proliferation test and healing-wound test. Compared with the control group, the proliferation and migration ability of Rac3-shRNA group was significantly decreased, while that of Rac3 high expression group was significantly increased (P < 0.01). Serum starvation test and Western Blot results showed that in A549 cell lines, the phosphorylation of ERK pathway was significantly reduced after Rac3 expression was knocked down by shRNA compared with the control group.
Conclusion
Rac3 is highly expressed in lung adenocarcinoma. The overall survival (OS) of patients with high Rac3 expression was significantly shorter than those with low Rac3 expression. Rac3 promotes the proliferation of lung adenocarcinoma cells. Rac3 promotes the migration of lung adenocarcinoma cells. Rac3 probably regulates the ERK signaling pathway to promote the proliferation in lung adenocarcinoma cells.
