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E.Y. Kim



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    P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P3.04-035 - Genetic Heterogeneity of Actionable Genes between Primary and Metastatic Tumor in Lung Adenocarcinoma (ID 676)

      09:30 - 09:30  |  Author(s): E.Y. Kim

      • Abstract
      • Slides

      Background:
      Because procedures obtaining lung cancer tissues involve high probability of critical complication, biopsies are usually done at a site of easy access. Authors questioned whether genetic information obtained at one biopsy site represent that of other lesion and is sufficient for therapeutic decision.

      Methods:
      Forty-one matched non-small cell lung cancer (NSCLC) samples of primary tumor and metastatic lymph node (L/N) were randomly selected from institutional tissue archives. non-synonymous mutation and ins-del of 16 genes that contain actionable mutations, intron 2 deletion polymorphism of Bcl2-like11, and copy number variation (CNV) of MET and FGFR1 were analyzed by NGS based technique.

      Results:
      A total 251 mutations, including 217 non-synonymous mutations, 30 deletions, and 4 insertions were discovered in this study. There were higher chances to discover non-synonymous mutations in the primary tumor than in the metastatic L/N (140 (64.5 %) vs. 77 (35.5%)). In the primary tumor, 106 G>A: C>T transitions (75.7%) out of 140 non-synonymous mutation were detected, whereas in the metastatic L/N 44 (57.1%) out of 77 were discovered, showing decrease of G>A: C>T transition in the L/N metastatic lesion. The proportion of C>G: G>C and C>T: G>A was 80.7% in the primary tumor and 67.5% in the metastatic L/N, showing APOBEC activity in the metastatic L/N was not prominent in this study model. When the mutation profile between primary and metastatic lesion were compared, 28 out of 41 (68.3%) cases showed identical mutation profiles whereas 13 (31.7%) showed discrepancy. Fifty out of 82 tested samples showed CNV of either FGFR1 or MET and 24 out of 41 cases showed discrepancy of copy numbers of tested genes between primary tumor and metastatic L/N.

      Conclusion:
      The genetic heterogeneity between the primary tumor and lymph node metastatic lesions are significant findings to consider when designing a therapeutic plan from a result of one site inspection. A large prospective study is needed to evaluate the impact of genetic heterogeneity on the clinical outcome of NSCLC patients.

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