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K. Kitano



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    P1.07 - Immunology and Immunotherapy (ID 693)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      P1.07-017 - Assessment of Cancer Immunity Status in Each Patient Using Immunogram (ID 9115)

      09:30 - 09:30  |  Author(s): K. Kitano

      • Abstract
      • Slides

      Background:
      For successful cancer immunotherapy, comprehensive profiling of cancer-immune system interaction is required for each individual patient. To this end, we developed an immunogram reflecting the cancer immunity cycle and applied it to real patients with lung cancer.

      Method:
      Whole-exome sequencing and RNA-Seq were performed in 25 non-small cell lung cancer patients (13 adenocarcinoma, 11 squamous cell carcinoma, and 1 large cell neuroendocrine carcinoma). The number of somatic mutations and the expression of genes related to cancer-immunity were assessed and normalized using TCGA-LUAD and LUSC data (n=1035). Immunogram of each patient was drawn in a radar chart composed of 9 axes reflecting 7 steps of cancer-immunity cycle.

      Result:
      Various patterns of immunogram were observed in all 25 lung cancer patients, suggesting that each patient has their own pattern of immunosuppressive microenvironment (Figure 1). The hierarchical clustering using each scores of immunogram showed four clusters of patients characterized by T cell phenotype (inflamed vs non-inflamed) and tumor antigenicity (high vs low) (Figure 2). T cell-inflamed tumors (Clusters 3&4) had gene signatures of abundant T cells and interferon gamma (IFNG) response, as well as inhibitory cells and checkpoint molecules, suggesting the presence of counter regulatory immunosuppressive microenvironment. Unleashing of counter regulations by checkpoint inhibitors, for example, may be indicated for these patients. Each scores of immunogram had no correlation with histology. This result was consistent with previous studies of checkpoint blockade that clinical responses were not easily predicted solely by the histology. Patient age, gender and TNM stage also did not correlate with each immunogram scores. Figure 1



      Conclusion:
      The landscape of the tumor microenvironment in each patient can be appreciated by utilizing immunogram. Immunogram for the cancer-immunity cycle can be used for the assessment and visualization of cancer immunity status in each patient, and thus may become a helpful resource toward optimal personalized immunotherapy.

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    P3.16 - Surgery (ID 732)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P3.16-028 - Necrosis Is a Predictor of Recurrence in Patients with Small Lung Adenocarcinoma ≦2cm (ID 10451)

      09:30 - 09:30  |  Author(s): K. Kitano

      • Abstract

      Background:
      The prognostic significance of pathological necrosis in small lung adenocarcinoma has not been investigated. The purpose of this study is to investigate the prognostic role of pathological necrosis in patients with completely resected small lung adenocarcinoma ≦2cm.

      Method:
      All available tumor slides from patients with surgically resected lung adenocarcinoma ≦2cm in size (1998-2015) were retrospectively reviewed. Exclusion criteria: patients who received induction therapy and lung cancer surgery within preceding 2 years. Recurrence free probability and overall survival were assessed using the Kaplan-Meier method.

      Result:
      351 patients met inclusion criteria (48% women, median age 67yr (34-86 yrs), 50% never-smokers; 324 Stage IA, 27 Stage IB; 111 and 240 patients underwent sublobar resection and lobectomy, respectively). Presence of pathological necrosis was identified in 32 patients (9%). Presence of pathological necrosis was significantly associated with sex, smoking, clinical T classification in the 8[th] edition and pathological tumor size (p<0.01, p<0.001, p<0.01, p<0.001, respectively). Presence of pathological necrosis correlated with an increased risk of recurrence, compared with those without pathological necrosis (5-year RFP, 70.5%vs 93.8%; p<0.001). Presence of pathological necrosis did not affect OS (5-year OS, 80.8%vs 92.3%; p=0.21).Figure 1



      Conclusion:
      In patients with small lung adenocarcinoma ≦2cm, presence of pathological necrosis was significantly associated with increased risk of recurrence.