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Y. Yihong



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    P1.11 - Poster Session 1 - NSCLC Novel Therapies (ID 208)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.11-036 - The efficacy and safety of sunitinib in EGFR-TKI pretreated advanced non-small cell lung cancer: a retrospective review from Chinese patients at a single institution (ID 2534)

      09:30 - 09:30  |  Author(s): Y. Yihong

      • Abstract

      Background
      Sunitinib is an oral, selective multi-targeted tyrosine kinase inhibitor (TKI) with antiangiogenic and antitumor activities. The result from a previous study suggested that the treatment of sunitinib might present favorable survival outcomes for the EGFR-TKI pretreated NSCLC Chinese patients. This study was therefore to evaluate the efficacy and toxicity of this therapeutic strategy.

      Methods
      This is a retrospective review of 30 stage IV NSCLC patients who received sunitinib as salvage therapy in Shanghai Chest hospital, from January 2009 until August 2011. All of the patients had previously been treated with EGFR-TKIs. Kaplan-Meier method was employed to estimate the median progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox proportional hazard regression analyses were carried out to determine the important prognostic risk factors influencing NSCLC survival.

      Results
      The median PFS of all 30 treated patients was 1.25 months (95% CI: 0.90-1.9 months), and the median OS was 3.40 months (95% CI: 3.00-6.80 months). Of the 29 patients eligible for efficacy evaluation, none achieved partial response. Cox regression analysis suggested that Eastern Cooperative Oncology Group (ECOG) performance status (PS) is predictive of both PFS (p=0.001) and OS (p<0.001). Hand-foot syndrome (53.3%), mucositis (40.0%), rash (36.7%) and diarrhea (33.3%) were most commonly reported adverse events.

      Conclusion
      In this study, the sunitinib treatment did not demonstrate overall clinical benefits to the EGFR-TKI pretreated NSCLC Chinese patients. Most side effects were mild to moderate. These results need further validation in prospective studies.

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    P2.06 - Poster Session 2 - Prognostic and Predictive Biomarkers (ID 165)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Biology
    • Presentations: 1
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      P2.06-027 - Low frequency KRAS mutations in colorectal cancer patients and the presence of multiple mutations in oncogenic drivers in non-small cell lung cancer patients (ID 2401)

      09:30 - 09:30  |  Author(s): Y. Yihong

      • Abstract

      Background
      Intra-tumor heterogeneity can confound mutational status in oncodriver genes and challenge targeted cancer therapy strategies. Ultra-deep sequencing can detect low-frequency and expanded clonal mutations in primary tumors to better inform treatment decisions

      Methods
      KRAS coding exons in 61 treatment-naïve colorectal cancer (CRC) tumors were sequenced, along with KRAS, EGFR, ALK, and MET in lung tumors from 3 Chinese non-small cell lung cancer (NSCLC) patients

      Results
      Forty-two percent of CRC patients (28/61) harbored mutations in the KRAS active domain, 12 patients harbored >1 mutation, and eleven patients (18%), of which 5 had frequencies <10%, were not detected by Sanger sequencing. Low frequency KRAS active (G12R) and EGFR kinase domain mutations (G719A) were identified in one NSCLC patient. Multiple low frequency mutations in KRAS, EGFR, and MET and ALK gene copy number increases were found in a second NSCLC patient; a third NSCLC patient had EML4-ALK fusion with ALK, EGFR, and MET mutations. Multiple low frequency mutations occurred within individual gene in all three patients.

      Conclusion
      A complex pattern of intrinsic low frequency driver mutations in well-known tumor oncogenes may exist prior to treatment, potentially resulting in resistance to targeted therapies. Ultra-deep sequencing can characterize intra-tumor heterogeneity and identify such mutations which could ultimately impact treatment decisions.