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Lizhu Lin
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P35 - Pathology - Genomics (ID 105)
- 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
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P35.12 - Assessment of Molecular Heterogeneity in Multiple Primary Lung Cancer Patients by Whole-Exome Sequencing (ID 1493)
00:00 - 00:00 | Presenting Author(s): Lizhu Lin
- Abstract
Introduction
Multiple primary lung cancer (MPLC) is relatively rare, with an occurrence ranging from 0.2 to 2% in lung cancer patients. Investigations of the clinical and molecular features of MPLC patients will provide useful information for the future diagnosis and treatment in this subset of patients.
Methods
Chinese patients with lung cancer involved multiple primary tumors including MPLC received whole-exome sequencing in the laboratory of 3DMed were analyzed. Clinical information and genomic alterations of the patients were collected.
Results
A total 25 tissue samples from 11 patients with reported multiple primary malignancies involving lung cancer were included for analysis. In overall, there are six MPLC patients with relative older ages (median 65.5, range, 58-67). Two primary tumor lesions were found in each of these six patients, with four of the patients harboring double lung adenocarcinoma (ADC) lesions, and two with ADC along with squamous cell carcinoma (SCC). In addition, five patients were diagnosed as multiple primary malignancies, with four involving ADC and one with SCC. Among these five patients, the other primary tumor sites including thyroid, stomach, esophagus, renal, breast, and bladder. A higher rate of ADC versus SCC was observed in lesions from either MPLC patients (83.3%, 10/12 vs 16.7%, 2/12) or lung cancer involved multiple primary tumors (80%, 4/5, vs. 20%, 1/5). Distinct molecular features (including driver gene sensitizing mutations) were observed from the multiple tumor lesions in each patient as shown in Table 1.
ConclusionTable 1. Detailed information of the studied patients. ID
Age
Sex
Cancer site and type
Pathogenic/Very likely pathogenic mutations
Pt01
58
Male
Lung, ADC
/
Tracheal cancer, SCC
EGFR gain; TP53 p.R337L; CDKN2A p.W110*; GTL3 gain; INHBA gain
Pt02
66
Female
Left upper lobe, lung ADC
EGFR gain; EGFR L858R; TP53 p.R342*; CDK4 gain; GTL1 gain
Right middle lobe, lung ADC
RBM10 p.Q148Rfs*26; PMS2 loss
Pt03
65
Female
Right lobe, lung ADC
EGFR L858R; MDM2 gain
Left lobe, lung ADC
/ Pt04
66
Male
Right lobe, lung ADC
EGFR p.E746_A750del; TP53 p.I232F; CTNNB1 p.S45F; IL7R gain; RICTOR gain
Left lobe, lung ADC
EGFR p.A767_V769dup; TERT c.-124C>T
Pt05
67
Male
Right upper lobe, lung SCC
KRAS p.G13C; KEAP1 p.E198*
Right lower lobe, lung ADC
FAT1 p.E183Nfs*21; FGFR1 gain; ADGRA2 gain; EPHA5 p.K509Rfs*22; KAT6A gain; TNK2 gain; ZNF703 gain; BCL6 gain
Pt06
64
Male
Right lobe, lung ADC
KRAS p.G12C; RBM10 p.Q595*
Left lobe, lung ADC
KRAS p.G12D; RBM10 c.1436-1G>T; ATM c.3077+1G>T
Pt07
47
Female
Left upper lobe, lung ADC
HIP1-ALK; SETD2 p.K1215Sfs*21
Thyroid cancer
BRAF p.V600E
Pt08
65
Male
Left upper lobe, lung ADC
ARAF p.Q349_F351delinsL
Gastric ADC
TP53 p.S241F; VHL loss; AR p.L57Q; CCNE gain
Mediastinal ADC
NF2 p.E327*; TET2 p.Y233*
Esophageal SCC
TP53 c.672+1G>T; TET2 p.Y233*; FGFR gain; NEK11 p.E265*
Pt09
66
Male
Right lobe, lung ADC
EGFR L858R; TP53 p.F270S
Right kidney, clear cell renal cell cancer
TET2 p.W54*; VHL p.H125Rfs*6; BAP1 p.N443Tfs*128
Pt10
34
Female
Right lobe, lung ADC
CDC73 c.908-6_913del
Left breast, breast cancer
EGFR gain; MYC gain
Right lobe, thyroid cancer,
BRAF p.V600E
Pt11
71
Male
Left lobe, lung ADC
/ Bladder, ADC
TP53 p.G334R; TP53 p.R175H; ASXL1 p.Q33Hfs*40; RAD50 p.E723Gfs*5; TERT c.-124C>T; TSC2 loss
Highly varied molecular alterations were observed in patients with multiple primary tumors. Comprehensive analysis of the tumor lesions are necessary to guide the optimal treatment strategies in cancer patients.
