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D. Liu



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    P1.01 - Advanced NSCLC (ID 757)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      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): D. Liu

      • 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.

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    P3.03 - Chemotherapy/Targeted Therapy (ID 719)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Chemotherapy/Targeted Therapy
    • Presentations: 1
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      P3.03-018 - Tumor Cavitation in Lung Metastases in Patients with Solid Tumor Treated with Apatinib (ID 9694)

      09:30 - 09:30  |  Author(s): D. Liu

      • 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.