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Z. Song
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-040 - A Comparison of ddPCR and ARMS for Detecting EGFR T790M Status from Advanced NSCLC Patients with Acquired EGFR-TKI Resistance (ID 3727)
14:30 - 14:30 | Author(s): Z. Song
- Abstract
Background:
To assess the ability of droplet digital PCR and ARMS technology to detect epidermal growth factor receptor (EGFR) T790M mutations from circulating tumor DNA (ctDNA) in advanced non-small cell lung cancer (NSCLC) patients with acquired EGFR-TKI resistance. A sensitive and convenient method for detecting T790M mutation would be desirable to direct patient sequential treatment strategy.To assess the ability of droplet digital PCR and ARMS technology to detect epidermal growth factor receptor (EGFR) T790M mutations from circulating tumor DNA (ctDNA) in advanced non-small cell lung cancer (NSCLC) patients with acquired EGFR-TKI resistance. A sensitive and convenient method for detecting T790M mutation would be desirable to direct patient sequential treatment strategy.
Methods:
A comparison of two platforms for detecting EGFR mutations in plasma ctDNA was undertaken. Plasma samples and tumor samples were collected from patients happening acquired EGFR-TKI resistance in Zhejiang cancer hospital from December 2014 to December 2015. Extracted ctDNA was analyzed using two platforms (Droplet Digital PCR and ARMS [dPCR]). And the associations between progression free survival (PFS) starting from initial TKI treatment and the T790M ctDNA status detected in plasma were analyzed.
Results:
A total of 108 patients were enrolled in this study. 108 patient plasma samples were detected by ddPCR and 75 were detected by ARMS. And 16 patients experienced re-biopsy were detected T790M status by ARMS method. 43.7% (47/108) had acquired T790M mutation by ddPCR. In 75 patient plasma samples, comparing ddPCR with ARMS, the rates of T790M mutation were 46.7% (35/75) and 25.3% (19/75) by ddPCR and ARMS, respectively. Of all, 16 patients both had tumor and plasma samples, the T790M mutation rates were 56.3% (9/16) by ARMS in tissue and 50.5% (8/16) by ddPCR in plasma ctDNA. Among them, there were two ctDNA T790M mutations by ddPCR but T790M gene negative in tumor tissue by ARMS method. For all patients, the median PFS and OS were 12.3 months and 32.8 months, respectively. The patients with T790M-positive tumors had a longer time to disease progression after treatment with EGFR-TKIs (median, 13.1 months vs 10.8 months; P=0.010) and overall survival (median, 35.3 months vs 30.3 months; P=0.214) compared with those with T790M-negative patients.
Conclusion:
Our study demonstrates dPCR assay provide feasibility and sensitive method in detecting EGFR T790M status in plasma samples from NSCLC patients with acquired EGFR-TKI resistance.And T790M-positive patients have better clinical outcomes to EGFR-TKIs than patients with T790M negative.
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P3.02b-093 - Zoledronic Acid Enhances the Effects of Icotinib on Non-Small Cell Lung Cancer Patients with Bone Metastases (ID 3958)
14:30 - 14:30 | Author(s): Z. Song
- Abstract
Background:
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are widely used as molecularly targeted drugs for the treatment of non-small cell lung cancer (NSCLC), with icotinib being one such EGFR-TKI. Bone metastases occur in 30–40 % of patients with advanced non-small cell lung cancer (NSCLC). Zoledronic acid is a third-generation bisphosphonate, and is effective for the reduction of the skeletal-related events (SREs). In addition, some reports have described the possibility of direct and indirect antitumor effects of zoledronic acid. However, most of these studies are preclinical research or combination with chemotherapy.
Methods:
We retrospectively analyzed data of 184 patients received icotinib with progression-free survival more than 6 months and used zoledronic acid at least once from July 2011 to May 2015 in Zhejiang cancer hospital. Progression free survival (PFS) and overall survival (OS) were calculated with the Kaplan-Meier method. Multivariate regression was performed using the Cox proportional hazards model.
Results:
A total of 184 NSCLC patients with bone metastases were treated with zoledronic acid and icotinib. 140 (76.1%) patients were with EGFR mutations (75 with deletions within exon 19, 63 with L858R messenger mutation in exon 21 and 2 with G719X mutation in exon 18). Median PFS of all patients during icotinib treatment was 10.7 months. The median overall survival (OS) time for all patients was 24.3 months. The PFS in ≥1 year and <1 year zoledronic group were 12.1 months and 10.2 months (P=0.351). And the PFS in the group of ≥2 years ZOL was longer than the group of <2 years zoledronic treatment (12.2 versus 10.5 months, P=0.175). The cumulative incidences of bone pain had not increased during 1 year zoledronic treatment than before ZOL treatment (31.0% versus 45.1%). 39 of the 92 patients in ≥1 year zoledronic treatment (39.1%) and 24 of the 92 patients in <1 year zoledronic (26.1%) experienced SREs before zoledronic acid treatment (P = 0.059). During zoledronic acid treatment, the incidence rate of SREs in group of ≥1 year and <1 year were 17.4% (16/92) and 13.0% (12/92), respectively.
Conclusion:
Hence, combined treatment of EGFR-TKI with zoledronic acid may have a more effective for NSCLC with bone metastases, particularly in EGFR mutation patients.
