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N. Tochigi
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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
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.07-044b - Pretreatment Neutrophil/Lymphocyte Ratio and the Efficacy of Nivolumab Treatment in Non–Small-Cell Lung Cancer (ID 9375)
09:30 - 09:30 | Author(s): N. Tochigi
- Abstract
Background:
The blood neutrophil/lymphocyte ratio (NLR) before ipilimumab administration is a useful predictive biomarker in the treatment of malignant melanoma. However, few studies have evaluated whether NLR can predict and overall survival in non–small-cell lung cancer (NSCLC).
Method:
We studied 38 patients with previously treated advanced NSCLC who had received nivolumab therapy between January 2016 and May 2017 at our hospital. Patients were divided into two groups (pretreatment NLR <5 or ≥5), and patient characteristics, treatment effect, adverse events, and immunohistochemical expression of programmed death ligand 1 (PD-L1) were evaluated in both groups.
Result:
Of the 38 patients, 12 had an NLR ≥5 and 26 had an NLR <5. Regarding patient characteristics, median PD-L1 expression on immunohistochemistry was significantly higher in the NLR <5 group than in the NLR ≥5 group (38.2% vs 1.7%, respectively; p = 0.049). The objective response rate was 39.1% vs 12.5%, respectively (p = 0.17), and the disease control rate was 95.7% vs 25%, respectively (p <0.001). The disease control rate significantly differed between groups, as did progression-free survival (median progression-free survival: 132 days in the NLR <5 group vs 49 days in the NLR ≥5 group; p = 0.009).
Conclusion:
Among patients treated with nivolumab for NSCLC, disease control rate and progression-free survival were better for patients in the NLR <5 group than for those in the NLR ≥5 group. The association between pretreatment NLR and immunohistochemical PD-L1 expression warrants further study.
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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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P2.01-010 - Risk Score for Predicting Acute Exacerbation after Chemotherapy in Lung Cancer Associated with Interstitial Pneumonia (ID 8094)
09:00 - 09:00 | Author(s): N. Tochigi
- Abstract
Background:
Fatal acute exacerbation (AE) of interstitial pneumonia (IP) may occur after chemotherapy for lung cancer. We developed and evaluated a scoring system for assessing the risk of AE after chemotherapy in patients with lung cancer associated with IP.
Method:
A review of medical records identified 107 patients with primary lung cancer associated with IP who had received chemotherapy during the period from June 2007 through September 2017. We developed a model to scoring AE risk after chemotherapy in lung cancer patients with IP, and logistic regression was used to evaluate this model.
Result:
The general score for anti-cancer agents was determined by using rates of AE reported in past studies. The risk score was calculated by using the following formula: (1 × anti-cancer agent general score) + (3 × smoking history [>70 pack-years]) + (4 × history of steroid medication) + (3 × %diffusing capacity of the lung carbon monoxide [<50%]). Patients were then classified into three groups. The AE rate was 12% for a risk score of 0–5, 47% for a score of 6–10, and 66.7% for a score ≥11. This sensitivity of the scoring system was 78.6%, and specificity was 67.8%.
Conclusion:
The present scoring system could identify IP patients at high risk for AE after chemotherapy for lung cancer.
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P3.15 - SCLC/Neuroendocrine Tumors (ID 731)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.15-016a - Prediction of Potential Biomarkers for Personalized Treatment in Pulmonary Large-Cell Neuroendocrine Carcinoma (ID 8869)
09:30 - 09:30 | Author(s): N. Tochigi
- Abstract
Background:
The prognosis for patients with large-cell neuroendocrine carcinoma (LCNEC) of the lung is extremely poor, and optimal treatment strategies have not yet been established. To improve prognoses in patients with LCNEC, we analyzed immunohistochemical expression and gene mutations of several known molecular targets in LCNECs and compared the expression levels of these targets with those in lung adenocarcinomas.
Method:
Twenty-six patients with primary LCNEC and 40 patients with adenocarcinoma were analyzed. Topoisomerase II, epidermal growth factor receptor (EGFR)-L858R, and somatostatin receptor expression were evaluated by immunohistochemistry, and EGFR mutations were evaluated using direct DNA sequencing and the Scorpion-amplified refractory mutation system.
Result:
There was no significant difference between patients with LCNEC and adenocarcinoma in relation to age, gender, smoking status, pathological stage (8[th]), performance status, and pulmonary function. In patients with LCNEC and adenocarcinoma, positive rates of topoisomerase II, EGFR-L858R, and somatostatin were 65.4% and 15.0% (p < 0.0001), 0.0% and 20.0% (p = 0.0182), and 50.0% and 5.0% (p < 0.0001), respectively. The frequencies of EGFR mutations were 0.0% and 37.5% in LCNEC and adenocarcinoma (p = 0.0002), respectively.
Conclusion:
LCNEC showed overexpression of topoisomerase II, somatostatin, suggesting it was possible to have good response to treatment with etoposide and octreotide compared with adenocarcinoma. EGFR mutations were not observed in LCNEC. These results may indicate a favorable response to adjuvant treatments that are not typically prescribed for non-small cell lung cancer.
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-004 - Surgery for Patients with Lung Cancer Associated with Interstitial Pneumonia (ID 9361)
09:30 - 09:30 | Author(s): N. Tochigi
- Abstract
Background:
Treatment of patients with lung cancer associated with interstitial pneumonia (IP) is difficult because of post-operative complications or treatment-related deaths. Indeed, post-operative acute exacerbation of IP in patients with lung cancer and IP is associated with a high mortality rate. In our institute, we have unified surgical methods and improved peri-operative management of such patients since 2013. In the current study, we retrospectively studied the clinical features, surgical methods, and peri-operative management, and analyzed the clinicopathologic features of patients with lung cancer associated with IP.
Method:
We selected patients with lung cancer associated with IP who underwent surgery from January 2004 to May 2017. A presumptive diagnosis of IP or an IP pattern on computed tomography (CT) was confirmed histologically by examination of resected specimens and/or the presence of the clinical diagnostic criteria. Acute exacerbation of IP was defined according to the guidelines of the Japanese Respiratory Society when the following criteria were fulfilled within 1 month: (1) increased respiratory distress; (2) fibrosis, newly developed ground glass opacity and infiltrative shadow on high-resolution computed tomography (HRCT); and (3) > 10 Torr decrease in PaO~2~ under the same oxygenation conditions. (4) no evidence of pulmonary infection, heart failure, pneumothorax, and pulmonary embolism. We studied the following clinicopathologic features in patients with lung cancer associated with IP: gender, age, surgical methods, pathologic stages, mortality rate, and post-operative complications, including acute exacerbation of IP.
Result:
Fifty-three patients underwent surgery. The mean age was 70.8 years (50 males and 3 females). Forty-three, 1, and 9 patients underwent lobectomies, a segmentectomy, and partial resections, respectively. Twenty-three, 17, and 13 patients were stage I, II, and III, respectively. Eight patients had post-operative acute exacerbations of IP and there were three in-hospital deaths caused by acute exacerbations. Of note, there have been no in-hospital deaths since 2013.
Conclusion:
It is possible to prevent severe post-operative complications in patients with lung cancer associated with IP with the aid of intra-operatively and optimal peri-operative management.
