Author of

• 31780

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  P2.17 - Treatment of Early Stage/Localized Disease (ID 189)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Treatment of Early Stage/Localized Disease
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31822

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    P2.17-36 - Molecular Markers, Therapeutic and Prognostic Analysis of Lung Sarcomatoid Carcinomas (ID 2973)

    10:15 - 18:15  |  Author(s): Zhen Wang
    • Abstract

    Background
    

    Several molecular markers have been established for therapeutic intervention and prognostic prediction of lung cancer. Less is known about their therapeutic potential and prognostic significance in less common lung cancer subtypes. The present study was therefore designed to assess a set of well-defined molecular markers in patients with lung sarcomatoid carcinomas and their therapeutic and prognostic significance.

    Method
    

    This is a single-center retrospective study of lung cancer patients with histologic types of the sarcomatoid carcinomas who underwent surgical resection at our center during August 2008 to August 2018. The molecular markers analyzed were driver mutations in EGFR, ERBB2, PIK3CA, C-MET, RAS, BRAF, EML4-ALK, RET and ROS1 by ARMS-PCR or NGS, protein expressions of PD-L1 (clone SP-142) in tumors and/or associated lymphocytes by immunohistochemistry. Log-rank test was used to compare the overall survival of patients.

    Result
    

    A total of 74 (1.18%) patients with sarcomatoid carcinomas were identified from 6,285 patients underwent surgical resection. Of the 35 patients underwent mutation testing (including 14 test EGFR and RAS by ARMS), 17 (48.57%) harbored driver mutations (12 RAS, 4 EGFR L859R and 4 EGFR 19del). Proteins expressions of PD-L1 were found in 67.86% of patients. No prognostic significance (DFS and OS) was noted regarding to any driver mutations and PD-L1 expression. Half of the patients (37/74, 50.00%) received adjuvant therapy, 27 of whom used platinum-based chemotherapy (72.97%). Platinum-based adjuvant chemotherapy showed improved DFS (P=0.011) but similar OS (P=0.079).

    Conclusion
    

    A part of lung sarcomatoid carcinomas harbor driver mutation or PD-L1 expression, although they are not prognostic. Platinum-based chemotherapy was preferable in these patients. The role of targeted or immune agents as adjuvant therapy needs further study.