Virtual Library
Start Your Search
Man Jiang
Author of
-
+
P1.01 - Advanced NSCLC (ID 757)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P1.01-042 - Dynamic ctDNA Assay by Next Generation Sequencing to Guide Targeted Therapy in Advanced Non-Small Cell Lung Cancer (ID 10387)
09:30 - 09:30 | Author(s): Man Jiang
- Abstract
Background:
It is difficult to identify tumor driving genes in advanced non-small cell lung cancer (NSCLC) patients especially for those who were unable to obtain cancer tissue samples and had developed treatment resistance. Circulating tumor DNA (ctDNA) has garnered much excitement over the past few years for its potential clinical utility as a tumor therapy monitoring tool. Our study aims to evaluate the usefulness of ctDNA for serial monitoring actionable genetic alterations in NSCLC patients.
Method:
34 pairs of matched cancer tissue and plasma samples were collected from patients with advanced NSCLC and applied to capture-based next generation sequencing (NGS) using the lung panel, consisting of critical exons and introns of 168 genes. Additional, serial monitoring of ctDNA was conducted in 11 NSCLC patients with actionable genetic alterations using the above NGS assay.
Result:
ctDNA yielded a close agreement of 85.3% (29/34) on actionable genetic alteration status when compared to cancer tissue at baseline in this study. Analysis of ctDNA at different time points showed a strong correlation to treatment efficacy. Interestingly, secondary genetic alterations such as EGFR mutation T790M were detected in 45.5% (5/11) of the patients during monitoring.
Conclusion:
ctDNA may be a potential alternative to conventional primary tissue based NGS assay. ctDNA assay by NGS could be clinically used to monitor the efficiency of personalized target therapy for NSCLC patients.
-
+
P1.01-069 - Clinical Experience with IBM Watson for Oncology (WFO) Cognitive System for Lung Cancer Treatment in China (ID 9774)
09:30 - 09:30 | Author(s): Man Jiang
- Abstract
Background:
IBM Watson for Oncology (WFO) is a Memorial Sloan Kettering-trained cognitive computing system. Watson provides evidence-based treatment options and ranks them into three categories for oncologist decision making as "Recommended ","For Consideration" and "Not Recommended". We examined the concordance of treatment options in Lung cancer patients between WFO and tumor board in the Affiliated Hospital of Qingdao University, China.
Method:
33patients with stage I-IV lung cancer were enrolled in this study. By tumor stage, 15.1% (5 of 33) patients are Phase I or II, 15.1% (5 of 33) are Phase III and the rest of the patients (23 of 33) are Phase IV. By histology, 18.2% (6 of 33) are small cell lung cancer (SCLC) and 81.8% (27 of 33) are non-small cell lung cancer (NSCLC). Options were considered concordant when it was included in the “Recommended” or “For Consideration” categories.
Result:
Overall, treatment recommendations were concordant in 96.9% (32 of 33) of cases. By histology, 100% of SCLC patients’ therapy regimes were concordant with the recommended one, and treatment recommendations were concordant in 96.3% of NSCLC patients. By tumor stage, treatment recommendations were concordant in 100% of I- III and 96% of Phase IV lung cancer. Of the whole cases, 69.7% were recommended and 27.3% were for consideration (figure1). The majority reason for choosing consideration option is that the immunotherapy drugs targeted PD-1 or PD-L1 such as Nivolumab, Pembrolizumab and Atezolizumab recommended by Watson for Oncology had not been launched in China.Figure 1
Conclusion:
Treatment recommendations made by the Affiliated Hospital of Qingdao University and Watson for Oncology were highly concordant in lung cancer. We’ll make further analysis for this cognitive computing system in more cases and other types of carcinomas.
-
+
P3.03 - Chemotherapy/Targeted Therapy (ID 719)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 2
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
-
+
P3.03-014 - Tumor Cavitation in Patients with Primary Lung Cancer Following Apatinib Treatment (ID 9054)
09:30 - 09:30 | Presenting Author(s): Man Jiang
- Abstract
Background:
Apatinib is a specific tyrosine kinase inhibitor that targets VEGFR-2. Treatment of primary lung cancer patients with apatinib is a new promising paradigm. In addition to hypertension and hand-foot syndrome, tumor cavitation and increase in CEA value are frequently noted in these patients. However, there are limited literatures regarding whether they could be used as potential biomarkers for anti-angiogenic therapy. This study was to evaluate the frequency and clinical outcome of primary lung cancer patients who developed tumor cavitation or showed increase in CEA value following apatinib treatment.
Method:
This was a retrospective analysis of primary lung cancer patients treated with apatinib in the Affiliated Hospital of Qiingdao University between 2/1/2015 and 5/19/2017. Clinical data were retrieved from medical records, and chest imaging findings were documented. Survival data were analyzed with Kaplan-Meier estimates and compared with log-rank test.
Result:
A total of 38 primary lung cancer patients received oral apatinib as the third-line or beyond therapy at an initial dose of 250 mg (n=37) or 500 mg (n=1) per day. During treatment, tumor cavitation was developed in 20 of the 38 (52.6%) patients. No significant difference was observed between patients with and without cavity formation in age, gender, tumor histology, tumor stage, history of pulmonary surgery and apatinib typical adverse events. Cavity formation was accompanied with temporary increase in CEA value (65.0% vs. 5.6% in patients with and without cavitary lesions; P=0.0001). The progression-free survival (PFS) of patients with cavitary lesions was 11.25 (95% CI, 10.16-13.64) months, which was significantly longer compared with those without (6.11 [95% CI, 6.01-6.71] months; P<0.0001). Besides, patients with a temporary increase in CEA had a longer PFS than those without (10.64 [95% CI, 10.09-14.14] vs. 6.14 [95% CI, 6.07-8.13] months), but the difference was not significant (P=0.0703).
Conclusion:
Cavitation formation induced by apatinib is common in primary lung cancer patients, and is not correlated with age, gender, tumor histology, tumor stage, history of pulmonary surgery and common adverse events. Cavitation might have significant effects on the temporary increase in CEA value and PFS prognosis.
-
+
P3.03-018 - Tumor Cavitation in Lung Metastases in Patients with Solid Tumor Treated with Apatinib (ID 9694)
09:30 - 09:30 | Presenting Author(s): Man Jiang
- Abstract
Background:
Apatinib, a specific tyrosine kinase inhibitor targeting VEGFR-2, shows anti-angiogenesis effects in multiple solid tumors including lung cancer. Correlation between cavitation formation and outcome of some anti-angiogenic drugs is evaluated in patients with pulmonary cancer. However, the onset of cavitation in lung metastases in solid tumor patients following apatinib treatment has not been mentioned yet.
Method:
The clinical data of solid tumor patients with lung metastasis treated with apatinib in the Affiliated Hospital of Qiingdao University between 4/1/2015 and 6/17/2017 were collected from medical records, and chest imaging findings were documented. Survival data were analyzed with Kaplan-Meier estimates and compared with log-rank test.
Result:
Sixty-four eligible patients were identified (Table). The main primary tumor sites were stomach (n=23, 35.9%), colorectum (n=14, 21.9%) and liver (n=10, 15.6%). 93.8% patients received 250 mg/day of apatinib orally. Tumor cavitation formation in lung metastases occurred in 20 (31.3%) patients. None of these patients had preexisting cavity, which demonstrated that all cavitary lesions were developed during apatinib administration. There was no significant difference in age, gender, primary tumor site, histology and stage of lung metastases, history of pulmonary surgery and typical adverse events of apatinib between patients developed cavity or not. Compared with those without cavitary lesions, patients with cavitary showed higher rate of temporary increase in CEA (85.0% vs. 34.1%, P=0.0002) and longer progression-free survival (PFS; 15.44 [95% CI, 12.12-20.65] months vs. 6.71 [95% CI, 6.11-8.13] months, P<0.0001). However, patients with temporary increase in CEA showed longer but not significant PFS (11.15 [95% CI, 6.71-15.44] vs. 8.13 [95% CI, 6.31-15.57] months; P=0.3047).Table Baseline characteristics
Characteristics Cavitation (n=20) No Cavitation (n=44) Age, years mean±SD 58.65±10.35 61.27±13.86 Gender, n (%) Male 13 (65.0) 33 (75.0) Female 7 (35.0) 11 (25.0) Primary tumor site, n (%) Stomach 4 (20.0) 19 (43.2) Colorectum 5 (25.0) 9 (20.5) Liver 6 (30.0) 4 (9.1) Other 5 (25.0) 12 (27.3) Histology of lung metastases, n (%) Adenocarcinoma 16 (80.0) 38 (86.4) Squamous cell ca 2 (10.0) 2 (4.6) Other 2 (10.0) 4 (9.1) Stage of lung metastases, n (%) IIIA 0 (0.0) 2 (4.6) IIIB 3 (15.0) 13 (29.6) IVA 10 (50.0) 20 (45.5) IVB 7 (35.0) 9 (20.5) History of pulmonary surgery, n (%) 8 (40.0) 8 (18.2) Treatment lines, n (%) 2 4 (22.2) 5 (11.6) 3 12 (66.7) 33 (76.7) 4 1 (5.6) 2 (4.7) 5 1 (5.6) 3 (7.0)
Conclusion:
Cavitation development in lung metastases is accompanied with temporary elevation of CEA in patients treated with apatinib, and might be used as a potential biomarker for survival free of progression.
