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Shaoyu Yang
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P1.03 - Chemotherapy/Targeted Therapy (ID 689)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.03-002 - Crizotinib-Associated Toxic Epidermal Necrolysis in an ALK-Positive Advanced NSCLC Patient (ID 7520)
09:30 - 09:30 | Presenting Author(s): Shaoyu Yang
- Abstract
Background:
Crizotinib is an oral small-molecule inhibitor of anaplastic lymphoma kinase (ALK) tyrosine-kinase that has been approved for treating patients with advanced echinoderm microtubule associated protein like 4-anaplasitic lymphoma kinase (EML4-ALK) rearranged non-small-cell lung cancer (NSCLC). Toxic epidermal necrolysis (TEN) is a rare adverse event related to crizotinib.
Method:
We report a case of 75-year-old Chinese male patient of advanced NSCLC harboring with ALK fusion, who developed TEN after 56 days of crizotinib treatment
Result:
the patient demised due to this dermatological adverse event
Conclusion:
The occurrence of severe cutaneous necrolysis that predominantly involve skin and mucous membranes during crizotinib treatment should alert clinicians to be aware of TEN and take prompt actions.
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P3.02 - Biology/Pathology (ID 620)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.02-040 - Driver Gene Detection in Chinese NSCLC Patients Using cSMART and Prognosis Analysis (ID 9044)
09:30 - 09:30 | Author(s): Shaoyu Yang
- Abstract
Background:
Circulating single-molecule amplification and resequencing technology (cSMART) based on next-generation sequencing is highly sensitive, accurate and quantificational. The purpose of this study is to detect the status of 9 driver genes in Chinese NSCLC patients using cSMART and analyze the associations of gene status, clinical characteristics and prognosis.
Method:
The tissue or plasma samples of 85 patients diagnosed NSCLC from Hangzhou First People’s Hospital were collected. EGFR, KRAS, ALK, ROS1, PIK3CA, c-MET, RET, BRAF and HER2 genes were combined detection using cSMART. The association between gene status and clinical characteristics was analyzed by chi-square test and Fisher’s exact. Kaplan-Meier survival curves were plotted for overall survival (OS) and analyzed with the log-rank test. Cox proportional hazards regression was used for multivariate analysis.
Result:
Amongst 85 NSCLC patients, EGFR mutations were more frequent (57.6%), followed by KRAS mutation (18.8%), ALK mutation (10.6%), ALK fusion (9.4%), MET mutation (9.4%), PI3KCA mutation (8.2%), ROS1 fusion (3.5%), BRAF mutation (1.2%), RET fusion (1.2%) and HER2 mutation was not found. Furthermore, the abundances of gene mutation were relatively low. The EGFR mutation rate was higher in patients with adenocarcinoma histology than in those with squamouscarcinoma histology (P=0.03). T790M mutation was more common in patients with a history of TKI treatment (P<0.01) and acquired T790M mutation was often accompanied by the original sensitive mutation (P<0.01). ALK fusion was more easily detected in tissue sample. All 8 MET gene exon14 skippings were found in adenocarcinoma histology and this gene alteration often happened after TKI treatment (P=0.02). OS was significantly improved in the EGFR mutation group compared with the wild group (median 32m vs 19m) (P=0.05). No significant survival difference between KRAS mutation and wild group was found (P>0.05). Among EGFR wild advanced NSCLC patients, the median OS of KRAS mutation group was 13 months while that of wild group was 26 months, but there was no significant difference (P>0.05). Multivariant analyses showed gender, TKI treatment history and smoking history were independent prognostic factors in NSCLC(P<0.05)．
Conclusion:
EGFR mutation is the most common driver gene in Chinese NSCLC, especially in adenocarcinoma patients, which often occurs in exon 19、20 and 21 region. Then followed by KRAS mutation, it mostly occurs in exon 2. MET gene exon14 skipping is common in patients with adenocarcinoma or post-TKI treatment, which may be related to TKI resistance. Gender, smoking history and TKI treatment history could be independent prognostic factors in NSCLC.
