Virtual Library
Start Your Search
Anne Marie Baird
Author of
-
+
P34 - Pathology - Liquid Biopsy (ID 104)
- Event: WCLC 2020
- Type: Posters
- Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P34.01 - Utility of Assessment of the EGFR Resistance Genotype using Cell-Free DNA and CTCs from Liquid Biopsies (ID 2321)
00:00 - 00:00 | Author(s): Anne Marie Baird
- Abstract
Introduction
In advanced disease, the presence of an EGFR mutation confers a more favourable prognosis and strongly predicts for sensitivity to EGFR tyrosine kinase inhibitors (TKIs). Clinical studies have demonstrated that ~20% of biopsies are inadequate for molecular testing due to insufficient tumour tissue. Tissue genotyping is further limited by often inaccessible tissue, heterogeneity and risks associated with serial tumour biopsies. More than 60% of patients who initially respond to EGFR TKI therapy develop resistance due to the emergence of the T790M or other resistance mutations. In this study, we hypothesise that concurrent assessment of circulating tumour cells (CTCs) and cell-free DNA (cfDNA) enhances assessment of EGFR resistance using the liquid biopsy as a non-invasive technology.
Methods
Patients with EGFR positive disease (n=21) were consented across three Irish Oncology Centres and stratified into cohort 1 (currently receiving EGFR TKI therapy) or cohort 2 (newly diagnosed, treatment-naïve patients to receive EGFR TKI therapy). Liquid (blood) biopsies were collected every 3 months over two years. Plasma genotyping of cell-free DNA was carried out using the FDA-approved Cobas® EGFR mutation test v2 (Roche Diagnostics) for the most common EGFR mutations across exons 18-21 of the EGFR gene. Analytical performance of the Cobas® EGFR mutation test was compared with two next generation sequencing (NGS) cell-free DNA panels (Oncomine & Avenio). In addition, the potential clinical utility of CTC numbers in monitoring response to therapy and the emergence of resistance (T790M) were assessed. CTCs were isolated from blood at each time-point using ScreenCell® size exclusion technology. Neutrophil to lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) were used as a measure of systemic inflammation and prognosis in this EGFR patient subset. Univariate Cox proportional hazards analysis was used for overall survival (OS) and time to progression (TTP).
Results
Plasma genotyping using the Cobas® EGFR mutation test identified Exon 19, L858R and L861Q mutations in 62%, 24% and 5% of liquid biopsy-derived cfDNA, respectively. The emergence of the T790M resistance mutation was detected in 57% of patients during treatment with EGFR TKIs. In contrast to cohort 2, patients in cohort 1 with a T790M had a worse OS and shorter TTP relative to patients with an EGFR sensitizing mutation. Using the Wilcoxon sign rank test, there were no significant correlations in EGFR mutation profile between the Cobas® mutation test and Oncomine (p=0.054) or Avenio (p=0.94) NGS panels. While there were no significant correlations between CTC numbers and T790M status in both cohorts, significant correlations were found between CTCs and WBC count (p=0.000073) and LDH (p=0.0010) in cohort 1 only. High CTC numbers correlated with a shorter TTP in both patient cohorts. This however was not statistically significant. Patients with T790M had a significant increase in inflammatory biomarkers (NLR, LDH, WBC) when examined across all time-points (p<0.05).
Conclusion
While larger prospective studies are warranted, these data add further knowledge to the use of cfDNA plasma genotyping and CTCs for the rapid detection of EGFR genomic alterations in patients with NSCLC during EGFR TKI therapy and treatment resistance.
-
+
P39 - Patient Advocacy (ID 168)
- Event: WCLC 2020
- Type: Posters
- Track: Patient Advocacy
- Presentations: 2
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P39.02 - ‘Making Moments Matter’ – A Lung Cancer Campaign from the Marie Keating Foundation (ID 2178)
00:00 - 00:00 | Presenting Author(s): Anne Marie Baird
- Abstract
Introduction
Lung cancer remains the most common cause of cancer related death in Ireland in both males and females. However, awareness of the signs and symptoms of the disease remain low, and people impacted by lung cancer face many challenges. Although recent advancements have resulted in improved five-year survival rates, they still remain poor at approximately 20%. Last year the Marie Keating Foundation launched the ‘Making Moments Matter’ campaign, which aimed to highlight the importance of more time for people diagnosed with lung cancer, and their families.
Methods
An integrated communications campaign was developed, which focussed on the personal experiences of those impacted by lung cancer. This also included updated information on lung cancer signs and symptoms on the Marie Keating Foundation website, PR and media activity (including a national radio ad), a video, and social media based campaigning. Central to the campaign was the creation of a shared space for lung cancer ambassadors to talk about their experiences and create individual memento jars. These jars served as a visual representation of the impact of a lung cancer diagnosis on a loved one and their family.
Results
The campaign ran in November 2019, and was well received. The social media campaign launched across Facebook, Twitter and Instagram, with a total reach of over 120,000 and an engagement of nearly 12,000. The radio ad, centred on the importance of early detection, and timely access to treatment and innovative drugs, had a reach of almost one and a half million. Visits to the Marie Keating Foundation lung cancer landing page also increased during the course of the campaign. Overall, the PR and media reach was approximately 3.5 million. The stories of our ambassadors and their memento jars reinforced the human impact of a lung cancer diagnosis on the person diagnosed and their family – representing their journey and their hopes for the future. These stories and images were shared in an effort to increase awareness of lung cancer, its early signs and symptoms and improve early detection rates.
Conclusion
This campaign helped to increase awareness of lung cancer signs and symptoms in a holistic manner. ‘Making Moments Matter’ created visual images of significant moments in the lives of those impacted by lung cancer, and also reflected on the moments that were missed through the death of a loved one. More must be done to increase early detection, access to treatment and new drugs as each extra moment is precious to everyone impacted by this disease.
-
+
P39.05 - Access Disparities and Challenges in Lung Cancer Diagnostics and Treatment – A European Perspective (ID 2214)
00:00 - 00:00 | Presenting Author(s): Anne Marie Baird
- Abstract
Introduction
Lung Cancer Europe (LuCE) is the voice of people impacted by lung cancer. Together with our member organisations we strive to make this disease an EU health priority. One of our main goals is to identify key challenges faced by the lung cancer community. These challenges are multifaceted and include inequalities in access to healthcare resources and services across Europe. This study was undertaken to assess issues with diagnostics and treatment across a number of European countries.
Methods
Data collection was undertaken using two online surveys (March until September 2019) using SurveyMonkey®; one conducted with healthcare professionals/researchers (34 respondents representing 19 countries) and the other conducted with pharmaceutical industry representatives (8/10 companies responded to the online survey, with an additional 5 providing information relating to compassionate use etc.). Data was collected for 7 molecular tests (ALK, EGFR, PD-L1, ROS1, BRAF, MET and KRAS). Twelve drugs and their indications were included as per approval by the European Medicines Agency (EMA). Data was validated by a final consultation with patient advocates (LuCE members), lung cancer experts and pharmaceutical companies in November 2019. Supplementary desk research was also performed.
Results
Delays in access to diagnostics were evident and varied between countries. However, four main access challenges were highlighted in the diagnostic pathway: EBUS-TBNA, CT guided biopsy, PET-CT and molecular testing. With regard to molecular tests, there were differences in the number of biomarkers tested and reimbursed in each country; as well as turnaround times for results. A Western/Northern and Eastern Europe divide was evident. In terms of innovative drug access, most of the drugs were not reimbursed in Eastern Europe. Many restrictions were identified in Latvia, Poland and Romania; as well as Croatia, Turkey,Ireland, Portugal, Slovenia, Spain and Italy. Access issues were also flagged for radiotherapy, surgery and clinical trials.
Conclusion
Timely availability to diagnostics and treatment is key to improved outcomes for people impacted by lung cancer. However, access to these critical core elements of the patient pathway are either slow, costly or absent for many people across Europe. Policy makers, healthcare and patient organisations must work together to overcome these barriers and ensure equal access to diagnostics and treatment for all people impacted by lung cancer, irrespective of their geographical location or socio-economic situation.
-
+
P76 - Targeted Therapy - Clinically Focused - EGFR (ID 253)
- Event: WCLC 2020
- Type: Posters
- Track: Targeted Therapy - Clinically Focused
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
-
+
P76.49 - The Impact of Baseline Systemic Inflammatory Status Parameters in Patients Treated with EGFR-Tyrosine Kinase Inhibitors (ID 2272)
00:00 - 00:00 | Author(s): Anne Marie Baird
- Abstract
Introduction
Elevated neutrophil to lymphocyte ratio (NLR),derived neutrophil to lymphocyte ratio (dNLR),lung immune prognostic index (LIPI) and circulating tumour cells (CTCs) are associated with inferior outcomes in non-small cell lung cancer (NSCLC). The use of these parameters in patients treated with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy is uncertain. We assessed the association of pre-treatment NLR, LIPI and CTCs on time to progression (TTP) and overall survival (OS) in patients treated with EGFR-TKIs.
Methods
Patients with existing EGFR-activating mutations on EGFR TKIs (cohort 1) and newly diagnosed, treatment naive (cohort 2) were recruited across three Irish Oncology centres over a two year period (n=21). Demographic characteristics were collected. Baseline NLR, dNLR (absolute neutrophil count/white blood cell concentration-absolute neutrophil count), LIPI (dNLR greater than 3 and LDH greater than ULN) consisted of 3 groups (good: 0 factors; intermediate: 1 factor; poor: 2 factors), and CTCs count was collected at baseline. CTCs were isolated from blood using ScreenCellÒ size exclusion technology.Cox proportional hazards analysis was used for overall survival (OS) and time to progression (TTP). Correlations were performed using the Wilcoxon sign rank test.
Results
16 (76%) of patients were female (median age 64.5), 20 (95%) were adenocarcinoma, 1 (5%) squamous cell carcinoma, 10 (48%) never smokers, 10(48%) ex-smokers.There was a significant correlation between LDH (p=0.02), CTCs (p=0.00067) and WCC in cohort 1. CTC count was also significantly correlated with LDH (p=0.001) in cohort 1. There was a significant correlation between LDH (p=0.003), NLR (p=0.0005) and WCC in cohort 2. NLR was also significantly associated with LDH (p<0.05). There was no significant correlation between dNLR and CTCs in either cohort. WCC, LDH, dNLR, CTCs and LIPI were not significantly associated with TTP and OS in either cohort.
Conclusion
Although there were positive correlations between baseline systemic inflammatory parameters, these were not prognostic for survival in patients treated with EGFR-TKI therapy. Larger clinical studies and sequential follow up parameter measurements during treatment will be valuable in assessing these markers during EGFR-TKI therapy.
