Author of

• 16549

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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)

  • 16621

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    P1.02-072 - Comprehensive Genomic Alterations Identified by Next-Generation Sequencing of Lung Adenocarcinoma in Japanese Population (ID 4602)

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

    Background:
    Therapeutic approaches to lung cancer have shifted toward an emphasis on molecularly targeted therapy in genotypic subsets of patients (pts). Recent advances in next-generation sequencing (NGS) technologies have improved the ability to detect potentially targetable mutations. In this study, we aimed to analysis the genomic alterations of lung adenocarcinoma.
    
    Methods:
    A retrospective analysis of genomic data obtained from 99 archived formalin-fixed, paraffin-embedded samples from Japanese pts with lung adenocarcinoma were analyzed by NGS panel of 415 genes. Mutations and frequency of variants present in key oncogenic drivers for each pts were quantified. Fisher’s exact and t-tests were used to identify associations between genomic alterations and clinical characteristics.
    
    Results:
    Sex: male 66 pts, female 33 pts. Smoking status: pack-year (PY) <30 (light smoker) 61 pts, PY≥30 (heavy smoker) 38 pts. Of all, the median number of mutation burden and actionable mutation were 13.5 (range 5-33) and 4 (range 1-19), respectively. The most frequent genomic alterations were EGFR (48%), TP53 (40%), CDKN2B (32%), RB1 (21%), and CDKN1B (19%). Representative genomic alterations with a FDA approved targeted therapy such as EGFR mutation (exon 19 deletion and exon 21 L858R), ALK fusion, ROS1 fusion, RET fusion, BRAF (V600E) mutation and, MET amplification were detected in 56 pts (R-GAs group) and the others were 43 pts (O-GAs group). In the O-GAs group, 39 pts had genomic alteration with targeted agent available on or off a clinical trial. As for smoking habit, R-GAs group were significantly associated with light smoker than O-GAs group (p<0.01). In R-GAs group, the median number of mutation burden and actionable mutation were 13 (range 5-20) and 4 (range 1-10), respectively. O-GAs group were significantly greater mutation burden and actionable mutation than R-GAs group (16.2 ± 6.8 vs. 12.3 ± 4.3, p<0.01; 6.5 ± 5.0 vs. 4.5 ± 2.2, p = 0.02, respectively). Of the 43 EGFR pts, there were no concurrent genomic alterations of ALK, ROS1, RET, BRAF and, MET. The most frequent concurrent mutations in EGFR were CDKN2B (37%), TP53 (28%), CDKN2A (23%), CDKN1B (21%), ARID1A (19%), RB1 (16%), and STK11 (16%). Among the EGFR cases, 38 (88%) pts had further genomic alteration with targeted agent available on or off a clinical trial excluding EGFR-TKI.
    
    Conclusion:
    With help of NGS, we found most pts might be treated by targeted therapies. Further study may emerge whether concurrent mutations, mutation burden and the number of actionable mutation are associated with survival outcome in lung adenocarcinoma.
    
    

• 18670

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  P3.04 - Poster Session with Presenters Present (ID 474)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18695

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    P3.04-025 - Repeated Lung Resection of Ipsilateral Lung Cancer That is Detected after Segmentectomy for Primary Lung Cancer (ID 4526)

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

    Background:
    Small peripheral lung cancer has increasingly been treated by segmentectomy as a limited resection for both curative and compromised intent. Few reports have described repeated resection of a new lesion originating in the lung of same side during postoperative follow-up.
    
    Methods:
    We experienced five cases of repeated ipsilateral lung resection after segmentectomy. Clinicopathological data and operative procedure were analyzed retrospectively.
    
    Results:
    Figure 1 The reason of limited resection for the first lung cancer was compromised intent in three cases and curative intent in two cases. Median time to second operation after initial resection was 63 months (20 to 106 months). Preoperative pulmonary function test before repeated operation was normal in all cases. In four cases, location of second cancer was in the same lobe of the first cancer. Procedure of repeated resection was partial resection in one, segmentectomy in two, completion lobectomy in one and completion pneumonectomy in one. All tumor were resected completely. There was no morbidity nor mortality. Histological diagnosis of second cancer was surgical-margin recurrence in two, second primary cancer in three. All cases except partial resection required intrapericardial vascular exposure due to severe adhesion around pulmonary artery and vein. Among five cases, completion lobectomy of the left upper lobe was the most difficult surgery due to adhesion between pulmonary artery and bronchus.
    
    
    
    Conclusion:
    Repeated resection of ipsilateral lung cancer detected after segmentectomy was undergone safely. The difficulty of the procedure depends on the location of the tumor and the type of procedures.