Author of

• 18502

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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)

  • 18588

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    P3.02c-086 - Genomic Heterogeneity in Tumors Demonstrating a Mixed Response to Nivolumab for Stage IV Squamous Cell Carcinoma of the Lung (ID 4149)

    14:30 - 14:30  |  Author(s): M.E. Menefee
    • Abstract

    Background:
    Mixed response (MR) to cancer therapy is a common, but poorly described phenomenon. MR represents a therapeutic dilemma and is defined by these criteria: 1. At least one tumor has increased in size while another has decreased. 2. One or more tumors have remained stable while another has increased 3. One or more tumors have remained stable while another has decreased 4. A new tumor has developed while other tumors either decrease or remain stable There is a paucity of data regarding both the incidence of this problem and potential mechanisms as to why it happens. Potential etiologies include: tumor heterogeneity; differences in tumor microenvironment; and discrepancies in drug delivery to different tumor deposits. It is also possible that MR simply reflects differences in the rate of resistance emerging. We sought to gain insights into MR in a patient with advanced SCC of the lung.
    
    Methods:
    A 65 yo female with squamous cell carcinoma of the lung received 1st-line therapy with cisplatin and gemcitabine followed by vinorelbine. She received 3rd-line therapy with nivolumab. Slight, generalized progression was observed after 4 cycles; however, the patient improved clinically, so treatment was continued. The MR was observed after cycle 8. Both a nonresponding and a responding tumor were biopsied. SCC was confirmed in both samples. NGS was performed.
    
    Results:
    Genomic Profiles for Discordant SCC Lung TumorsFigure 1
    
    
    
    Conclusion:
    This is the first study known to the authors to genomically profile tumors demonstrating a mixed response to systemic therapy. The clinical significance of these aberrations and discrepancies is uncertain. Nevertheless, genomic discrepancies may provide some insight into why MR occurs and this may provide evidence for rational combinatorial therapeutics in patients in who experience a MR. More importantly, it may provide insights into developing novel combinations that may prevent the occurrence of MR.