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M. Ghosh



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    P2.03b - Poster Session with Presenters Present (ID 465)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.03b-064 - Genomic Profiling in Non Small Cell Lung Cancer: New Hope for Personalized Medicine (ID 4174)

      14:30 - 14:30  |  Author(s): M. Ghosh

      • Abstract
      • Slides

      Background:
      Lung cancer is rich in molecular complexities and spurred by different molecular pathways. Personalized medicine has begun to bring new hope to people with lung cancer, especially non-small cell lung cancer (NSCLC). Personalized medicine involves looking at the cells obtained from a biopsy to see if there are any genetic mutations able to exploit these unique pathways to develop targeted therapies. Very few publications are there from India related to lung cancer and genomics by Next generation Sequencing (NGS).

      Methods:
      The patients with NSCLC with initially negative for EGFR by PCR and ALK by IHC or FISH method treated at HCG Hospital from Jan-2013 to April -2016 are subjected for Gene profiling. The patients were consented to be profiled by targeted deep sequencing for hotspot mutations in 48 cancer-related genes using Illumina’s TSCAP panel and MiSeq technology. The average coverage across 220 hot spots was greater than 1000X. Data was processed using Strand Avadis NGS™. Mutations identified in the tumor were assessed for ‘actionability’ i.e. response to therapy and impact on prognosis.

      Results:
      . A total of 65 patients were analyzed. Male: Female ratio- 2.6:1. In 11 patients NGS were rejected due to poor quality DNA tumor availability in paraffin blocks. In 19 patients didn’t find any actionable mutation. The pathogenic mutations were identified in remaining 35 patients. The following mutations were found. (table)

      Types of mutations Number of cases
      TP 53 18
      EGFR 7
      EGFR , T790M 3
      PIK3CA 4
      K-RAS 4
      N-RAS 1
      KDR 2
      RET 2
      PTEN 3
      MPL 1
      HER2 1
      MET 1
      CTNNB1 1
      ATM 1
      Out of 35positive patients, 13 had two mutations and 43.75% could offer targeted therapy. 38% of them responded to therapies who were treated with targeted drugs.

      Conclusion:
      There is a potential role for PIK3CA, EGFR +/- T790M, KDR, RET and PTEN as therapeutic targets as personalized therapy in NSCLC. Present study helps us in understanding the diversity of molecular drivers in lung cancer and its clinical management for these patients, along with understanding of prognosis.

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