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Kaiqi Du



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    EP1.03 - Biology (ID 193)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Biology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.03-05 - A Meta-Analysis of Association Between Serum Iron Levels and Lung Cancer Risk (ID 94)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      Many studies conducted on the relationship between serum iron levels and lung cancer risk had produced inconsistent results. We therefore conducted a meta-analysis to determine whether serum iron levels were lower in lung cancer patients compared to those in controls.

      Method

      A literature survey was conducted by searching the PubMed, WanFang, CNKI, and SinoMed databases for articles published as of Mar 1, 2018. Standard mean differences (SMD) with the corresponding 95% confidence intervals (CI) were executed by Stata 12.0 software.

      Result

      A total of 13 publications involving 1118 lung cancer patients and 832 controls were included in our study. The combined results showed that serum iron levels in lung cancer cases had no significantly lower when compared to those in controls [summary SMD = -0.125, 95%CI= -0.439, 0.189, Z = 0.78, p for Z test= 0.435], with high heterogeneity (I2= 89.9%, P< 0.001) found. In the stratified analysis by geographic locations, consistent results were found for serum iron levels between lung cancer patients and controls both in Asian populations [summary SMD = -0.113, 95%CI= -0.471, 0.245] and European populations [summary SMD = -0.215, 95%CI= -0.835, 0.404].

      Conclusion

      Publication bias was not found when evaluated by Begg’s funnel plot and Egger’s regression asymmetry test.In summary, the current study showed that serum iron levels had no significant association on lung cancer risk.

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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: 3
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.14-33 - Intestinal Metastasis from Primary ROS1-Positive Lung Adenocarcinoma Patients Responding to Crizotinib (ID 105)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      Small intestinal metastases from primary lung cancer are rare. Such patients have a poor prognosis. Early diagnosis of small intestinal metastases is difficult because of the low incidence of clinically apparent symptoms. The standard treatment for small intestinal metastases has not been established.

      Method

      A 69-year-old Chinese man presented for evaluation of a tumor in the right lower lung and mediastinal lymph node enlargement on clinical examination. The clinical stage was cT2N2M0 (stage IIIA). Histologic examination of the tumor revealed lung adenocarcinoma.

      Result

      He received two chemotherapy regimens. However, the disease progressed. He had bloating after chemotherapy and decreased flatus. An abdominal CT scan showed an intestinal effusion with local intestinal obstruction. Medical treatment was ineffective; hence, he underwent a diagnostic laparoscopy. The pathologic evaluation suggested an intestinal metastatic adenocarcinoma from the primary lung cancer. Based on an real-time PCR assay, the tumor had a ROS1 fusion and responded well to crizotinib. The progression-free survival was 7 months.

      Conclusion

      Physicians must be aware of the possibility of intestinal metastases from primary lung cancer. With an accurate diagnosis and thorough evaluation, patients may benefit from targeted therapy.

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      EP1.14-46 - The KIF5B-RET Fusion as a Novel Mechanism of Acquired EGFR Tyrosine Kinase Inhibitor Resistance in Lung Adenocarcinoma (ID 103)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      Lung cancer is a common malignancy and a leading cause of cancer deaths worldwide. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. And most NSCLC patients with epidermal growth factor receptor (EGFR) mutations respond well to the treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Unfortunately, almost all patients with effective EGFR-TKIs therapy eventually develop drug resistance in about 1 year. The most common mechanism of acquired resistance to first-generation EGFR-TKI treatment is the development of the T790M mutation in exon 20 of the EGFR, which occurs in almost one half of cases of acquired resistance.

      Method

      In this case report, we present a 72-year-old male non-smoker patient with an EGFR exon 19 deletion diagnosed with lung adenocarcinoma (LADC), who initially responded to first-generation EGFR-TKI treatment, but developed acquired resistance, and was shown to have gene detected by the next generation sequencing.

      Result

      Repeated liquid biopsy showed the KIF5B-RET fusion gene by next generation sequencing. Therefore, cabozantinib was added to the treatment, and stable disease (SD) was achieved. Unfortunately, the patient did not acquire long-term benefits and the progression-free survival (PFS) was only 2 months

      Conclusion

      Our results suggested that the KIF5B-RET fusion gene is a possible novel cause of acquired resistance to first-generation EGFR-TKIs.

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      EP1.14-47 - Lung Adenocarcinoma with Concurrent KRAS Mutation and ALK Rearrangement Responding to Crizotinib (ID 108)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      Chromosomal translocation resulting in the fusion between the echinoderm microtubule-associated protein-like 4 (EML4) gene and the anaplastic lymphoma kinase (ALK) gene has been considered as a novel oncogenic fusion in a subset of non-small cell lung cancer (NSCLC), mostly in non-smokers with adenocarcinoma. EML4-ALK translocations are commonly reported to be mutually exclusive with EGFR or KRAS mutations.

      Method

      We reported a rare case of 47-year-old female was diagnosed with lung adenocarcinoma and treated with three cycles of chemotherapy. A biopsy acquired after disease progression revealed concurrent KRAS mutation and ALK translocation by a NGS assay.

      Result

      Based on molecular findings, treatment was initiated with crizotinib in September, 2016. After 2 months of therapy, the patient achieved a partial response. Afterwards, the patient was further administrated with crizotinib for 9 months with a stable disease before tumor progression.

      Conclusion

      A further understanding of the molecular biology with multiple oncogenic drivers will promote the optimal treatment for NSCLC.

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    EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 3
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.16-23 - The Efficacy of S-1 in the Third or More Than Line Treatment of Advanced Non-Small Cell Lung Cancer Patients (ID 1127)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      S-1 as the third generation of fluorouracil derivate with well safety and low toxicity, presented some efficacy in lung cancer treatment. The aim of this study was to evaluate the efficacy of S-1 treatment in advanced non-small cell lung cancer (NSCLC) in a real world.

      Method

      We explored the efficacy of S-1 in advanced NSCLC patients with previously treated from 2015 to 2018 in Jiangshan People′s Hospital, Zhejiang Rongjun Hospital and Zhejiang Cancer Hospital. Platinum or the third-generation chemotherapy drugs could be combinedly used. Clinical response was assigned every cycle according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Survival analysis and univariate survival analysis were performed by the Kaplan-Meier method.

      Result

      158 patients were included in the research. These patients received S-1 treatment were as a third-line or more-line therapy, including 63 patients S-1 monotherapy, the other 95 patients combined regimens. All 158 NSCLC patients had therapeutic evaluation. Six patients were partial response (PR), and 51 patients were stable disease (SD), then an overall response rate (ORR) was 3.80% and a disease control rate (DCR) was 36.08%. Median progression-free survival (mPFS) was 1.94 months (95%CI 0.56-10.98), no difference between monotherapy and combined group (DCR 30.16% vs 40.00%, P>0.05), the liver metastasis showed poorer PFS (1.29 months vs 1.92 months , P<0.05).

      Conclusion

      S-1 presented some activity in advanced NSCLC treated with more than third lines of treatment. The addition of other drugs cannot improve efficacy. S-1 monotherapy can be used as a choice for heavily-treated patients.

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      EP1.16-33 - QT Prolongation in an EGFR 19 Deletion Lung Adenocarcinoma Patient from Icotinib Treatment (ID 92)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      An increasing number of tyrosine kinase inhibitors (TKIs) are available for the treatment of non-small cell lung cancer (NSCLC). QT prolongation is one of the known, but relatively rare, adverse events of several TKIs (e.g. osimertinib, crizotinib). Screening for QT prolongation in (high risk) patients is advised for these TKIs. When a QT prolongation develops, the physician is challenged with the question whether to (permanently) discontinue the TKI.

      Method

      In this perspective, we report on a patient who developed a QT prolongation during icotinib (a first-generation epidermal growth factor receptor [EGFR]-TKI) treatment.

      Result

      On discontinuation of icotinib, he developed a symptomatic disease flare, not responding to subsequent systemic treatment. The main aim of this perspective is to describe the management of QT prolongation in stage IV EGFR 19 deletion mutation NSCLC patients. We also discuss the ethical question of how to weigh the risk of a disease flare due to therapy cessation against the risk of sudden cardiac death. A family history of sudden death and a prolonged QT interval might indicate a familiar long QT syndrome.

      Conclusion

      We have summarised the current monitoring advice for TKIs used in the treatment of lung cancer and the most common druge TKI interactions to consider and to optimise TKI treatment in EGFR mutation patients.

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      EP1.16-34 - Survival Analysis of Icotinib for Brain Metastases in EGFR Mutated Non-Small Cell Lung Cancer (ID 112)

      08:00 - 18:00  |  Author(s): Kaiqi Du

      • Abstract

      Background

      Survival and treatment options are limited for patients with brain metastases arising from non-small cell lung cancer (NSCLC). The aim of this study is to investigate the efficacy and survival analysis icotinib treatment for brain metastasis in non-small cell lung cancer patients with EGFR mutation.

      Method

      We retrospectively reviewed NSCLC patients with brain metastases who were treated with icotinib, and the survival rate was calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates. Univariate and multivariate factors for survival were analyzed by COX proportional hazards regression model.

      Result

      116 cases of rain metastases in EGFR mutated non-small cell lung cancer were female, less than 60 years old and non-smoking patients predominant; COX multivariate analysis found that histologic subtype and EGFR gene subtype were independent prognostic factors for these patients.

      Conclusion

      Icotinib showed promising efficacy in NSCLC patients with brain metastases. PFS and OS was longer in patients with adenocarcinoma than in those with a non-adenocarcinoma subtype. PFSand OS was longer in patients with EGFR common mutations than EGFR uncommon mutations.

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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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      P2.14-09 - Concurrent TP53 Mutation Adversely Impact the Efficacy of Crizotinib in ROS1-Rearranged Lung Cancer Patients (ID 2158)

      10:15 - 18:15  |  Author(s): Kaiqi Du

      • Abstract

      Background

      ROS1 tyrosine kinase inhibitors (TKIs) are now standard of care for patients with advanced ROS1-rearranged NSCLC. But factors that may affect the efficacy of ROS1 TKIs remain to be explored.

      Method

      We conducted a retrospective multicenter study of lung cancer patients with ROS1 rearrangements. Treatment and survival follow-up was done and clinical records were reviewed. PFS distribution was analyzed by Kaplan-Meier method with log-rank test.

      Result

      In total, we included 94 lung cancer patients with ROS1 fusion genes profiled by next-generation sequencing from May 2016 to September 2018. Fifty of them were female. The median diagnosis age was 54 (25-83). The most common histologic type was adenocarcinoma, which was confirmed in 75 of 78 patients with available pathological results. The most common fusion partners were CD74, EZR, SDC4 and SLC34A2 identified in 42, 19, 12 and 8 patients respectively. Concurrent actionable mutations were uncommon for ROS1 fusion-positive patients. The most frequent concomitant mutated gene was TP53, which was detected in 33% of all the patients. After excluding 29 patients who were lost to follow-up at the very start, the median follow-up time was 8.5 (0-28) months from the moment when mutation profiling was performed. Thirty-nine patients received treatment with crizotinib, among whom 27 were treatment-naïve patients. The median PFS of the 39 patients with crizotinib was not reached yet. Patients with baseline CNS metastasis tend to have shorter PFS compared to patients without (median, 12 vs NR, p = 0.0073). Besides, concurrent TP53 mutations were correlated with worse PFS (median, both NR, p = 0.0417). Mutation profiles of 10 patients were derived from ctDNA testing. No difference was found in PFS between these 10 patients with others whose genomic profiles were based on fresh tissue or FFPE specimens, suggesting that plasma ctDNA serves as good specimen source for mutation profiling to monitor clinical treatment.

      Conclusion

      Concurrent TP53 mutation and presence of CNS metastasis are associated with decreased PFS of ROS1-positive patients treated with crizotinib.

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    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
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.16-39 - The Association Between Dietary Protein Intake and the Risk of Lung Cancer: A Meta-Analysis (ID 200)

      10:15 - 18:15  |  Author(s): Kaiqi Du

      • Abstract

      Background

      Dietary protein intake had been explored whether had some effective on lung cancer risk, however, the results were not consistent. This meta-analysis aimed to find exact relationship between them.

      Method

      Databases of PubMed, Embase, and Web of Science were retrieved up to January 1, 2019. Summarized odds ratio (OR) with corresponding 95% confidence intervals (CI) were calculated. Publication bias and sensitivity analysis were assessed.

      Result

      Seven articles with 8 independently studies (4 population-based case-control studies (PBCC) and 4 hospital-based case-control studies (HBCC)) involving 2990 cases and 7142 participants were used in this paper. The overall analysis suggested that dietary protein intake had no significant association on lung cancer risk (Summarized OR= 0.951, 95%CI= 0.798-1.134, I2= 53.0%, P for heterogeneity= 0.037). However, when we explored the association between lung cancer risk and geographic location, we found an inverse association among Asian populations (Summarized OR= 0.880, 95%CI= 0.840-0.922), instead of North American populations or European populations.

      Conclusion

      Findings from this meta-analysis indicated that higher intake of protein may be associated with decreased of lung cancer risk among Asian populations, instead of other populations. As some limitations listed in our study, more studies are warranted to further confirm the association between them.