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R. Bowman



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    P1.03 - Poster Session with Presenters Present (ID 455)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P1.03-065 - Comparison of the Proposed IASLC 8th TNM Lung Cancer Staging System to the 7th Edition (ID 6230)

      14:30 - 14:30  |  Author(s): R. Bowman

      • Abstract

      Background:
      We performed a validation study of the proposed International Association for the Study of Lung Cancer (IASLC) 8[th] tumour, node, metastasis (TNM) and grouping revisions on the non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) in our Institution, where we are a regular contributor of a subset of cases for the IASLC TNM staging revision projects.

      Methods:
      Data was collected from the Queensland Cancer Control Analysis Team (QCCAT) Queensland Oncology Online (QOOL) registry of NSCLC or SCLC cases presented to The Prince Charles Hospital (TPCH) between 2000 and 2015. It was validated against Queensland Integrated Lung Cancer Outcomes Project (QILCOP) registry with case identification number, first name, last name, and date of birth. Cases were classified according to IASLC TNM revisions 7[th] edition and then according to the proposed TNM revisions and stage groupings where data available. Kaplan-Meier curves were plotted and survival differences tested with Log-Rank test using SPSS Statistics ver. 23.

      Results:
      The entire study population consisted of three thousand six hundred and thirty-seven cases. One thousand three hundred and ninety-two non-surgical patients had complete clinical staging and one thousand and fifteen patients with pathological staging were identified. Median survival in clinical staging by the 7[th] edition showed progressive reduction in median survival with increasing Stage (IA:1480, IB:714, IIA:715, IIB:391, IIIA:399, IIIB285, IV:196; days) which was similar in the proposed 8[th] edition staging noting small numbers in IA1 (IA1:1385, IA2:2098, IA3:1004, IB:801, IIA:550, IIB:589, IIIA:448, IIIB285, IIIC:265, IVA:218, IVB:106; days). A similar pattern was reflected in pathological staging 7[th] edition TNM staging (IA:3725, IB:3486, IIA:1796, IIB:1209, IIIA:841, IIIB:587, IV:869; “days) and in the proposed 8[th] edition staging (IA1:1929, IA2:3586, IA3:3804, IB:3640, IIA:2977, IIB:1796, IIIA:949, IIIB:723, IVA:869; “days”). Log-Rank test in all the survival curves were <0.001.

      Conclusion:
      Conclusions: The proposed 8[th] edition TNM classification appears to be a more refined predictor of prognosis. However, our cohort only had small sample sizes for Stage I cases, which need validation and further hazard ratio and multivariate analysis is recommended. Acknowledgements: patients and staff at TPCH and UQTRC

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    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-015 - Genomic Characterisation of Non-Small Cell Lung Cancer in an Australian Population (ID 4052)

      14:30 - 14:30  |  Author(s): R. Bowman

      • Abstract

      Background:
      Lung cancer is a heterogeneous disease with poor prognosis. Genomic variants may predict sensitivity to targeted drug therapies or assist in prognostication. We sought to determine the frequency of driver mutations and gene rearrangements in non-small cell lung cancer (NSCLC) and evaluate the feasibility of the MassARRAY system for multiplexed mutational profiling.

      Methods:
      A cohort study of 419 fresh-frozen NSCLC tumours was performed (AC, n=370; SCC, n=39; ASC, n=7; LCC, n=3). High-throughput and multiplexed mutational profiling was performed using the MassARRAY genotyping system (Agena Bioscience) (n=419). The OncoFOCUS+KIT panel was used for detecting genomic variants in EGFR, BRAF, KRAS, NRAS and KIT (n=413) and the LungFusion panel for fusion genes involving ALK, RET and ROS1 (n=371). Clinico-pathological associations were evaluated using Fisher’s exact test for categorical data, and T test for continuous data. A p-value of <0.05 (two-tailed) was considered statistically significant.

      Results:
      At least one genomic variant was detected in 196 (46.8%) cases (n=419). EGFR mutations were identified in 42 cases (10.2%), KRAS in 133 (32.3%), BRAF in 11 (2.7%), NRAS in 4 (1.0%) and no KIT mutations were detected. Gene rearrangements involving ALK, RET and ROS1 were identified in 2 (0.5%), 1 (0.3%) and 5 (1.3%) cases respectively. Based on current clinical guidelines for NSCLC, 28 patients would qualify for tyrosine kinase inhibitor therapy, and 4 for targeted therapy available for other cancers (BRAF V600E). EGFR mutations were significantly associated with adenocarcinoma histology and female never smokers (p<0.001) and KRAS mutations predominated in smokers (p<0.001).

      Conclusion:
      Driver mutations were detected in 46.8% of NSCLC cases resected at TPCH. Rapid, multiplexed mutation testing can guide treatment as well as assist in patient stratification for clinical trials.