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G. Anguera
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P1.02 - Poster Session with Presenters Present (ID 454)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.02-067 - Repeated Biopsy for Immunohistochemical and Mutational Analysis of Non Small Cell Lung Cancer: Feasibility and Safety (ID 4442)
14:30 - 14:30 | Author(s): G. Anguera
- Abstract
Background:
Repeated biopsy in lung cancer may be necessary at diagnosis or after cancer progression on initial therapy to properly target treatments. The objective of this study is to evaluate the feasibility and safety of repeated biopsy for immunohistochemical and/or mutational analysis in patients with non small cell lung cancer.
Methods:
We have retrospectively analyzed repeated biopsies performed in patients with advanced non small cell lung cancer during the last 4 years. The technical success rates for the repeated biopsy and the adequacy rates of specimens were evaluated. Biopsy-related complications were recorded. Clinical details were collected, specially focusing in EGFR mutation data.
Results:
110 repeated biopsies were performed in 74 patients (34 women, 40 men, mean age 63 [36-84]), the histology was: 74% adenocarcinoma, 12% squamous cell carcinoma, 11% NOS, 3% other. The mean number of repeated biopsies per patient was 1 (1-4). The main reasons for repeated biopsy were immunohistochemical +/- mutational analysis (34/110, 31%), mutational analysis (16/110, 14.6%) and EGFR at progression (28/110, 24.4%). The technical success rate for biopsy was 98/110 (89.1%), and postprocedural complications occurred in 3/110 cases: 2 pneumothorax and 1 wound infection. Biopsy specimens came mostly from primary tumor (56/110, 51%), lymph nodes (26/110, 23.6%) and pleura (9/110, 8.2%), the most used technique was bronchoscopy +/- EBUS (45/110, 40%), followed by percutaneous transthoracic lung biopsy (28/110, 26%) and thoracoscopy and/or mediastinoscopy: (19/110, 17%). Results from repeated biopsy were used to select the next line of treatment in 86/110 procedures (78%), and 40/86 of them (46.5%) allowed to include the patient in a clinical trial. 28 repeated biopsies were performed in 21 EGFR mutant lung cancer patients with acquired resistance at disease progression, T790M was detected in 13/28 (46%) of samples, corresponding to 10/21 (47.6%) EGFR mutant lung cancer patients.
Conclusion:
Our data demonstrate that repeated biopsy in non small cell lung cancer is safe and clinically feasible. Findings from repeated biopsy were used to direct subsequent treatment in 78% of patients.
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P2.04 - Poster Session with Presenters Present (ID 466)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.04-013 - Prognosis Factors and Survival Analysis in Thymic Epithelial Tumors (ID 5919)
14:30 - 14:30 | Author(s): G. Anguera
- Abstract
Background:
Thymic epithelial tumors (TET) include thymomas (T) and thymic carcinomas (TC). TET are rare malignant tumors usually associated with paraneoplastic syndromes (PNPS). The objective of the study is to describe our experience and to analyze the prognostic factors.
Methods:
Retrospective analysis of the clinical and pathological characteristics of 42 patients (pts) diagnosed with TET in our institution from 1990 to 2016. We analysed the outcomes in terms of progression-free survival (PFS) and overall survival (OS) and their association with clinical factors: age, perfomance status, presence of PNPS, TNM staging, WHO classification, complete resection and treatment. Kaplan Meier method and Cox regresion were used.
Results:
Mean age:55 years (27-86). 19 (45.2%) : women. First treatment: surgery in 34 pts (81%) and platinum based chemotherapy in 6 pts (14%). 2 pts (5%) were untreated. 14 pts (41%) received postoperative radiotherapy. WHO classification: 6 pts (14.3%) type A, 12 (28.6%) AB, 3 (7.1%) B1, 7 (16.7%) B2, 7 (16.7%) B3 and 7 (16.7%) C. TNM staging: 20 pts (48.8%) stage I,4 (9.8%) stage II, 6 (14.6%) stage III and 9 (22%) stage IV. 25 ptss (59.5%) had PNPS at diagnosis: 21 (50%) myasthenia gravis, 2 (4.75%) aplastic anemia and 2 (4.75%) others. Table 1 shows OS and PFS according to WHO classification:
The presence of PNPS were associated with better OS than those without PNPS (236m , 95%CI 147-448m vs 66.5m, 95% CI 1.3-131.7m, p=0.006, HR 0.76, p=0.026 ) and also with early diagnosis (stage I for pts with PNPS 56% vs 42% without PNPS ). In the multivariate analisys, only C type remained stadistically significant (HR:13.5, p=0.024). No diferences were found when using TNM classification or complete resection.WHO C WHO: A, AB, B1, B2, B3 p value HR (univariate) p value PFS (months)(95%CI) 21.2 (5.8-36.7) 89.3(69.1-109.6) 0.03 3.12 0.04 OS (monthS)(95%CI) 66.5 (0-157.5) 296 (98.6-493.3) <0.001 20.2 0.007
Conclusion:
Patients with C type TET had worst prognosis. The presence of a PNPS is associated with better OS possibly due to and early diagnosis.
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P3.02c - Poster Session with Presenters Present (ID 472)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02c-080 - The Beneficial Effect of Platelet Binding to Monocytes on the Clinical Response to Checkpoint Inhibitors (ID 6032)
14:30 - 14:30 | Author(s): G. Anguera
- Abstract
Background:
Nivolumab is an immune checkpoint inhibitor that reactivates cytotoxic T cells against tumor cells in non-small cell lung cancer (NSCLC) patients (pts). There are many ongoing efforts to find predictive biomarkers for immune checkpoint inhibitors. We have previously reported that platelet can selectively bind to leukocytes and, as a consequence, modify their function. To evaluate whether this modification is relevant for the response to checkpoint inhibitors, we determined the percentage of different subsets of leukocytes with bound platelets in the peripheral blood of pts before starting treatment with Nivolumab.
Methods:
Peripheral blood samples were collected at baseline from patients with NSCLC candidates for receiving Nivolumab. After labeling cells with antibodies specific for lymphocytes, monocytes and neutrophils, we added anti-CD41a mAbs (specific for platelets). We next determined the percentage of PDL1+ cells and CD41+ cells in each leukocyte subset by flow cytometry. These results were compared in patients with different clinical response by one-way ANOVA. The clinical response was determined by RECIST v1.1 criteria.
Results:
From January 2015 to February 2016, we collected peripheral blood from 12 pts (4 females and 8 males). Mean age at time to starting Nivolumab was 73 (range 53-86). 4 pts were smokers and 8 former smokers. 5 pts were had squamous cell carcinoma and 6 non-squamous cell carcinoma. 6 Pts received Nivolumab in second line and 6 patients in third line. Response after 3 months with Nivolumab: 4 patients with partial or complete response, 4 patients with stable disease and 4 with progressive disease. There were no differences in the baseline percentages of CD4+, CD8+, Natural Killer cells, B lymphocytes, monocytes and neutrophils among the three groups of response. By contrary, the proportion of monocytes with bound platelets (CD14+CD41+/ total monocytes) was significantly higher in patients with response to nivolumab than those with stable or progressive disease (90.28+7.63%, 33.92+7.02 and 61.44+19.5% respectively, p=0.002). And Also, the PDL1 expression on monocytes was different between the three groups (1.9+0.16, 4.37+1.05 and 2.39+0.73 respectively, p=0.003).
Conclusion:
The functional modification induced by the platelet binding to the monocytes seems to be beneficial for the clinical response to checkpoint inhibitors.
