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N. Monnamo
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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
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-129 - Prognostic Factors and Biomarkers in Large Cell Carcinoma and Neuroendocrine Tumors of the Lung in the Thai Population (ID 1669)
09:30 - 09:30 | Author(s): N. Monnamo
- Abstract
Background:
There are limited data on prognostic factors and biomarkers of large cell carcinoma and neuroendocrine tumors of the lung (LCC/NETs) due to decreasing prevalence and the lack of large epidemiological studies. This study describes the natural history and clinical behavior of the disease including exploration of molecular alterations of LCC/NETs in the Thai population.
Methods:
Patients who had a diagnosis of LCC/ NETs of the lung from January 2000 to August 2014 were identified from the tumor registry of Ramathibodi Hospital. Data on the natural history and clinical behavior of the disease were collected. The association and predictive ability of patient and tumor characteristics with overall survival (OS) and recurrence-free survival (RFS) outcomes were examined, respectively. In 46 patients with adequate tumor tissue, Ki-67, neuroendocrine markers, CD117, HER-2, PDL-1, ALK, and IGF1-R were evaluated by immunohistochemistry staining (IHC). In addition, EGFR, PIK3CA and BRAF V600E mutations were evaluated by real time PCR.
Results:
Medical records of 191 patients were reviewed. OS rates at 1 year for small cell lung cancer (SCLC), neuroendocrine carcinoma (NEC) and LCC were 39.7%, 63.6% and 32.6%, respectively. The RFS rates at 1 year for SCLC, NEC and LCC were 25.4%, 10.6% and 14.0%, respectively. There were 3 significant factors predicting for better survival outcomes. These included age, ECOG performance status, and receiving chemotherapy. There was no difference in Ki-67 expression between the SCLC and LCC/NEC groups. In the molecular analysis, 10.8% of patients expressed ALK, 41.3% expressed CD117 (c-KIT), 23.9% expressed PDL1, and 78.3% expressed IGF1-R. In the mutational analysis, 4.9% of patients had a PIK3CA mutation, and 9.8% had an EGFR mutation. 19 out of 46 patients (41.3%) who had positive CD117 expression had better 1-year survival rate than the negative group (68.4% vs 29.6%, P=0.018). No c-kit mutation was found in exons 9 and 11. Figure 1
Conclusion:
Our study provided strong evidence for clinical features (age, ECOG performance status, receiving chemotherapy) as prognostic factors for LCC/NETs of the lung. CD117 expression is a useful biomarker to predict OS. While earlier studies with Imatinib in both SCLC and NSCLC were negative, further mechanistic studies in the role of CD117 in LCC/NETs may yield therapeutic insights. Finally, larger studies to further explore the molecular alterations of LCC/NETs of the lung are needed.
