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Hong Tang
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P1.01 - Advanced NSCLC (ID 757)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.01-047 - Analysis of EGFR Mutation Status in CSF and Blood in Lung Adenocarcinoma Patients with EGFR Mutation and CNS Metastasis (ID 9717)
09:30 - 09:30 | Author(s): Hong Tang
- Abstract
Background:
Patients with non-small cell lung cancer（NSCLC）harboring epidermal growth factor receptor (EGFR) mutations benefit a great deal from EGFR tyrosine kinase inhibitors(TKIs). However, most patients get recrudesced within one or two years, and many of them progressed in central nerve system（CNS）.Owing to the blood– brain barrier, detecting tumor-derived cell-free DNA (cfDNA) in the blood of brain metastasis tumor patients is challenging. Detecting tumor-specific mutations in cerebral spinal fluid (CSF) became an alternative method.
Method:
41 initial or progressed lung adenocarcinoma patients with EGFR mutation and CNS metastasis from Henan Cancer Hospital were included in this study. 41 patients were all detected EGFR mutation status in CSF with dropplet digital PCR (ddPCR) and 37 in 41 patients were detected EGFR mutation status in blood with the same method. Their clinical informations were also collected at the same time.
Result:
The rate of EGFR mutations in CSF （15/41，36.6%）were obviously lower than that in blood（24/37，64.9%）（P=0.013), especially in those with EGFR exon 19del mutation patients (7/18 vs 13/16, P = 0.017), without TKIs treated patients (3/13 vs 8/11,P = 0.038) and less than 60 years patients (10/25 vs 17/22, P = 0.010). In patients with CNS symptoms positive, the rate of EGFR mutations in CSF was higher than those negative (13/27 vs 2/14 , P=0.033). In patients with MRI indicating leptomeningeal metastasis, the rate of EGFR mutations in CSF was higher than those not indicating(8/11 vs 7/30 , P=0.003).Clinical characteristics, EGFR mutation status in CSF and plasma (n = 41)
Characteristic n(%) Gender Male 23 (56.1) Female 18 (43.9) Age ≥ 60 16 (39) < 60 25 (61) Smoking status Yes 12 (29.3) No 29 (70.7) Brain metastases (MRI) Only metastatic tumors 30 (73.2) With meningeal lesions 11 (26.8) Brain metastatic tumor number Single 10 (24.4) Multiple 31 (75.6) Neurological symptoms Positive 15 (36.6) Negtive 26 (63.4) Prior TKIs treat Yes 28 (68.3) No 13 (31.7) CSF EGFR mution 19 7 (17.1) 21 6 (14.6) Both 2 (4.9) Negtive 26 (63.4) Blood EGFR mution 19 13 (31.7) 21 10 (24.4) Both 1 (2.4) Negtive 13 (31.7)
Conclusion:
The EGFR mutations status in CSF is different from that in blood in patients with EGFR mutation and CNS metastasis. This warrants confirmation in larger cohorts and further more studies are needed to find out the internal mechanism. Detecting EGFR mutations status in both blood and CSF will be helpful to make individualized treatment.
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-042 - Perioperative Chemotherapy with Pemetrexed and Cisplatin for Pulmonary LCNEC: A Case Report and Literature Review (ID 9892)
09:00 - 09:00 | Presenting Author(s): Hong Tang
- Abstract
Background:
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is associated with poor prognosis, and its treatment strategy is still controversial, especially chemotherapy regimens.
Method:
Case Report: A 49-year-old Chinese male with primary pulmonary LCNEC treated by neoadjuvant and adjuvant chemotherapy with cisplation plus pemetrexed was presented in this paper. A suspected quasi-circular mass in the left lower pulmonary lobe and an enlarged mediastinal lymph node were found. The patient was diagnosed with adenocarcinoma with neuroendocrine differentiation based on CT guided percutaneous lung biopsy. EGFR gene mutation test showed negative results. Cisplatin and pemetrexed were administered as the neoadjuvant chemotherapy regimen. The primary lesion had remarkably reduced and the enlarged mediastinal lymph node had disappeared after two cycles of neoadjuvant chemotherapy. He was performed left lower lobectomy and mediastinal lymph node dissection. The lesion was confirmed as LCNEC based on postoperative histopathological analysis and immunohistochemical results.
Result:
The patient underwent four cycles of adjuvant chemotherapy with cisplation and pemetrexed for a month postoperatively, followed by postoperative adjuvant radiotherapy. The patient is still alive after a follow-up of 24 months, with no evidence of tumor recurrence.
Conclusion:
Cisplatin combined with pemetrexed is effective and safe for patients with pulmonary LCNEC.
