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Yanye Wang



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    P07 - Early Stage/Localized Disease - Imaging and Biomarkers (ID 116)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P07.03 - The Impact of PD-L1 Expression on the Prognosis of Early-Stage Resected NSCLC: A Meta-Analysis of Literatures. (ID 1024)

      00:00 - 00:00  |  Author(s): Yanye Wang

      • Abstract
      • Slides

      Introduction

      Previous studies have demonstrated that programmed cell death-ligand 1 (PD-L1) serves as a poor prognostic biomarker for the survival in advanced-stage non-small-cell lung cancer (NSCLC) patients. However, the value of PD-L1 expression for the prognosis of early-stage NSCLC patients after complete resection remains controversial. Here, we conduct a meta-analysis to investigate the relationship between PD-L1 expression and prognosis in resected NSCLC.

      Methods

      Electronic databases, including PubMed, EMBASE, and the Cochrane Library, were searched up until June 30 2019, for studies evaluating the expression of PD-L1 and prognosis of the resected NSCLC. Hazard ratios (HRs) with 95% confidence interval (CI) of overall survival (OS) and disease-free survival (DFS) were pooled and analyzed. Heterogeneity and publication bias analyses were also performed.

      Results

      A total of 15 studies involving 3501 patients were enrolled. The pooled hazard ratio (HR) showed that PD-L1 expression was related to a much shorter DFS (HR =1.63, 95% CI: 1.26-2.12, P=0.022), as well a significantly worse OS (HR =1.68, 95% CI: 1.32-2.14, P=0.000). Furthermore, our analysis indicated that PD-L1 expression was significantly associated with gender (male vs. female: HR=1.25, 95% CI:1.02-1.52, p=0.028), tumor stage (III/IV vs. I/ II: HR= 2.39, 95% CI:1.85-3.08, p=0.000), lymph node metastasis (N+ vs N-: HR=3.54, 95%CI:2.56-4.88, p=0.000) and smoking status (Yes vs No: HR=1.37,95% CI:1.20-1.560, p=0.000).

      Conclusion

      The results of this meta-analysis suggest that PD-L1 expression predict an unfavorable prognosis in early-stage resected NSCLC. The role of individualized anti-PD-L1/PD-1immunotherapy in the adjuvant settings of resected NSCLC is worthy of being further investigated.

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    P38 - Pathology - Pathology/Staging (ID 108)

    • 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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      P38.11 - Clinical and Molecular Characteristics of TSC1/2 Mutant Lung Cancer (ID 1154)

      00:00 - 00:00  |  Presenting Author(s): Yanye Wang

      • Abstract
      • Slides

      Introduction

      Tumor suppressor genes TSC1 and TSC2 inhibit cell growth through inactivation the function of mTORC1. Previous studies have demonstrated that loss of function mutation of either TSC1 or TSC2 gene result in formation of neoplasm in multiple tissues. However, the clinical significance of TSC1 and TSC2 in non-small-cell lung cancer (NSCLC) remains unknown. This study aimed to investigate the clinical and molecular characteristics of TSC1 and TSC2 mutation in NSCLC patients.

      Methods

      We retrieved the clinical and genomic information of 1144 NSCLC from the Pan-Lung cancer dataset through the cBioportal (www.cbioportal.org). The cohorts of TSC1 and TSC2 mutant patients were identified. We compared baseline characteristics of patients with the Fisher exact test for categorical data and the Mann-Whitney U test for continuous variables. Overall survival (OS) was estimated with Kaplan-Meier curves, and differences were compared with the log-rank test.

      Results

      Among 1144 patients, 27(2.36%) of them had TSC1 mutation and 40 (3.50%) had TSC2 mutation. Most patients with TSC1 and TSC2 mutations coexisted with other oncogenic gene alterations. TP53 was the most frequent concurrent gene (n=53), followed with ERBB family genes (n=24) and KRAS (n=15). Compared to squamous cell carcinoma, TSC1/2 mutation was slightly more common in adenocarcinoma (53.7% vs 46.3%). 61.2% TSC1/2 mutant patients were male and 88.1% patients had former/current smoking history. Kaplan–Meier analysis showed that the patients harboring TSC1 mutation had a median OS of 14.1 months, whereas patients with TSC2 mutation had a median OS 110.6 months. However, there was not a statistically difference (P=0.201).

      Conclusion

      TSC1/2 mutation may define a unique population of NSCLC, which often coexists with other oncogenic gene alterations such as TP53 mutation. The function of TSC1/2 mutation and the value of TSC1/2 as therapeutic target in NSCLC are under investigation.

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    P81 - Immunotherapy (Phase II/III Trials) - Immunotherapy Plus Chemotherapy/Immune Checkpoint Inhibitor Single Agent (ID 258)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Immunotherapy (Phase II/III Trials)
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P81.02 - Neoadjuvant PD-1/PD-L1 Immune Checkpoint Inhibitors in Solid Tumors (ID 733)

      00:00 - 00:00  |  Author(s): Yanye Wang

      • Abstract
      • Slides

      Introduction

      Neoadjuvant therapy can improve outcome by increasing the resection rate, down staging the primary tumor and improving postoperative survival. PD-1/PD-L1 inhibitors have been approved in the treatment of advanced lung cancer, breast cancer, melanoma and other common cancers, and its success has moved immunotherapy forward to the early stage setting. In this study, we summarized the ongoing clinical trials which focus on neoadjuvant immunotherapy in solid cancers, and discussed their treatment strategy, efficacy and adverse events.

      Methods

      A comprehensive search regarding PD-1/PD-L1 inhibitors monotherapy or combination therapy in neoadjuvant settings of twelve types solid cancers was performed in the PubMed, Cochrane, and Embase databases, and the abstracts of various conferences were screened. Paired reviewers selected studies for inclusion and extracted data. All clinical trials are confirmed to be FDA approved or registered on clinicaltrials.gov.

      Results

      Our review indicates that the preoperative treatment of PD-1/PD-L1 inhibitors combination results in a high objective response rate (ORR), major pathologic response (MPR) rate and pathologic complete response (pCR) rate. Responding patients are more likely to achieve MPR and pCR. Neoadjuvant regimens containing PD-1/PD-L1 inhibitors cause more side effects, however, most of the side effects can be alleviated and do not cause significant surgical delay. Data from melanoma, head and neck carcinoma as well as gastroesophageal junction carcinoma suggests that patients with pathological remission after neoadjuvant immunotherapy have better post-operative disease-free survival.

      Conclusion

      Neoadjuvant immunotherapy, especially with a combination regimen, seems very effective and well tolerated in patients with early-stage resectable cancers. However, it is still unclear that the advantage of pathological response from neoadjuvant immunotherapy could translate into an overall survival benefit. Neoadjuvant immunotherapy is for several reasons worthy of being further investigated.

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