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Francisco III Maramara Heralde
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P2.02 - Biology/Pathology (ID 616)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.02-019 - Utility of Circulating Tumor DNA (CtDNA) in Prognostication of Lung Cancer vs. Other Cancer Types (ID 10488)
09:30 - 09:30 | Presenting Author(s): Francisco III Maramara Heralde
- Abstract
Background:
The detection of circulating tumor cells and the corresponding expression of tumor genes has been utilized as a prognostication tool for assessing therapeutic response to various anti-cancer therapies including immune cell therapy, chemotherapy and natural products-based anti-cancer therapy at the Lung Center of the Philippines (LCP) since 2014. Recently, circulating tumor DNA (ctDNA) has emerged as a new promising test for noninvasive detection of several cancers including lung cancer. This study aims to evaluate the utility of ctDNA in prognostication of lung cancer vs. other cancer types.
Method:
Blood sample from cancer patients (7.5 ml) were extracted for DNA and RNA using the QIAamp Circulating Nucleic Acid Kit, Qiagen, and subjected to two tests, 1) detection of EGFR mutation using the therascreen EGFR Plasma RGQ PCR Kit, and 2) detection of tumor gene expression level using an in-house two gene panel (i.e. EGFR and ERBB2). Three groups were compared, group A (Lung cancer, 7 cases), group B (Breast cancer, 7 cases) and group C (one case of Ovarian, one case of Colon and one case of Mixed Epithelial). The protocol is approved by the Technical and Ethics Review Board of the hospital.
Result:
Data show that in groups B and C, no EGFR mutation was detected while in group A, two out of 7 cases showed Exon 19 Deletion. The in-house two gene panel showed group A to have two cases of upregulated ERBB2 (i.e., 5-9.5 folds), group B to have three cases of upregulated ERBB2 (i.e., 1.6-6.5 folds) and one upregulated EGFR (i.e., 15.7 folds) and group C to have one case of upregulated ERBB2 (i.e., 7.4). ctDNA with therascreen for EGFR mutation detection has less sensitivity (i.e.2/17) as compared to ctDNA with in-house two panel for tumor gene expression (i.e., 7/17), although specific to detect EGFR-associated lung cancer. The data also suggest a possible preponderance of copy number-driven cancer as compared to mutation-driven cancer in these set of patient samples.
Conclusion:
ctDNA-based tumor detection can be useful as a prognostication tool however it should be in combination with a compatible detection platform that may indicate copy-number driven or mutation-driven cancer.
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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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P3.02-056 - EGFR Mutation Profile of NSCLC Patients Tested at the Lung Center of the Philippines (ID 9992)
09:30 - 09:30 | Author(s): Francisco III Maramara Heralde
- Abstract
Background:
EGFR mutation testing has been established as a companion diagnostic for targeted therapy of Non-Small Cell Lung Carcinoma (NSCLC). The Lung Center of the Philippines (LCP) established a program with pharmaceutical companies (Roche and Astra-Zeneca) to conduct free EGFR testing for several NSCLC patients. This report aims to showcase the EGFR mutation profiles observed and their implication to targeted therapy among Filipino patients.
Method:
Tumor block specimens from patients clinically diagnosed with NSCLC at stages II to IV with at least 5% density of histopathologic tumor cells were extracted with DNA and subjected to EGFR mutation analysis using the Roche EGFR mutation detection kit and Cobas Quantitative Real Time PCR. The laboratory test was UKNEQAS certified to assure the quality and validity of results.
Result:
EGFR positive specimens were detected at 42.6% (260/611) in cohort A and 42.4% (42/99) in cohort B close to the values earlier reported by our laboratory (i.e., 47.5%). For A, 14 mutation types were detected. For B, only 7 were detected. The dominant mutations in both A and B were Exon 19 Deletion (i.e., 58.8% and 54.5% respectively) and Exon 21 L858R (i.e., 27.7% and 21.4% respectively). The Exon 20 T790M, a mutation that confers TKI resistance, was detected in both cohorts associated with Exon 19 Deletion (i.e., 1.9% in A and 4.8% in B). The same mutation was also detected in A associated with Exon 21 L858R but at low rate (i.e., 0.8%). Gender-wise, there were twice as much females as males that were positive for the EGFR mutation. The average age were 60.1 for males and 59.8 for females.
Conclusion:
The EGFR mutation profile showed that more mutation types are detected with sample size increase; the dominant mutation occurs in Exon 19 Deletion with count twice as much as Exon 21 L858R. The Exon 20 T790M mutation was detected in conjunction with these two mutations at less than 5%.
