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Jessica Li
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P06 - Early Stage/Localized Disease - Multiple Primary Lung Cancer (ID 115)
- 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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P06.03 - Regression of the Ground Glass Component in Patients with Multifocal Primary Lung Cancers Receiving Pembrolizumab (ID 2078)
00:00 - 00:00 | Presenting Author(s): Jessica Li
- Abstract
Introduction
With the use of HRCT and lung cancer screening program, patients with multifocal primary lung cancers (MPLCs) are becoming a growing population in clinical practice worldwide. It's a rising challenging as no established treatment guideline. Having >= 1 Ground Glass nodule (GGN) or Part-Solid Nodule (PSN) suggests MPLC. Many of these GGN/PSN are pre-/early invasive, or preneoplastic, which is shown to have better preserved immune contexture, and therefore could benefit from immunotherapy (IO). This study is to evaluate potential beneficial effect of IO the pre-/early invasive adenocarcinoma in patients with MPLC.
Methods
We retrospectively reviewed CT in 13 stage IV NSCLC with MPLCs (9F: 4M, 70±4 yrs, 3CS vs. 10ES). All had tumor proportion score of PD-L1 ≥ 50% in dominant tumors and received first-line pembrolizumab. We evaluate disease response to pembrolizumab using RECIST 1.1 and the change of GGNs and PSNs (in addition to the dominant tumor) to pembrolizumab.
Results
27 GGNs/PSNs were found on 13 patients at baseline (16 GGN, Di: 13±6mm, 11 PSNs, Di entire nodule/solid core: 19±8/11±7mm). Over 267±196 days on pembrolizumab, 8 patients had radiographic partial response (PR) while 5 had progressive disease. 6 GGNs and 4 PSNs in 3/8 patients with PR improved: 3/6 GGNs (Di=7, 10, 12mm) have completely resolved and ther other 3/6 GGNs decreased (Di: from 9, 14, 21 to 3, 3, 7mm, Fig1); in 4 PSNs, their GGO component has completely resolved with only solid core at FU CT (Di entire nodule/solid core at baseline: 19±6/12±8mm; Di solid core at FU: 11±6mm, Fig2). The other 17/27 (10 GGNs and 7 PSNs) have unchanged/enlarged despite of similar baseline size to the regressed ones (GGNs: 13±6mm; PSNs: 20±10/10±6mm).
improved
Treatment with pembrolizumab resulted in the regression of the GGO component of the GGN and PSN. Further investigation of use of IO for patients with MPLC is warranted.