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R. Rzazade
Author of
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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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P2.01-063 - Outcomes of Patients with Oligometastatic Non-Small Cell Lung Cancer Who Were Treated with Radical Treatment (ID 8816)
09:00 - 09:00 | Author(s): R. Rzazade
- Abstract
Background:
Patients with oligometastatic non-small cell lung cancer (NSCLC) represent an indolent phenotype who may benefit from aggressive therapy and experience long-term overall survival (OS). Previous several small retrospective studies have showed that aggressive therapies for both the primary tumor and the metastases might be beneficial for patients with oligometastatic NSCLC compared with patients that did not receive aggressive treatment. The aim of this study was to determine the efficacy of aggressive treatment for patients with oligometastatic NSCLC.
Method:
We retrospectively analyzed 40 patients with oligometastatic NSCLC who were treated with aggressive treatments. Response rates, progression-free survival (PFS) and OS were evaluated.
Result:
Median age was 58 years, the majority of patients were male (67.5%), and have adenocarcioma histology (77.5%) and ECOG PS 0-1 (92.5%). Oligometastase locations were brain (55%), adrenal gland (22.5%), bone (15%), lung (5%), and other (2.5%). Oligometastatic disease was mostly limited: 80% of patients had metastases confined to one involved organ, and the majority of patients (57.5 %) presented with a solitary metastasis. Primary tumor treatments were concomitant chemoradiotherapy (60%), surgery (17.5%), chemotherapy (17.5%) and sequential radiotherapy (5%). On the other hand, metastase treatments were consisted of radiosurgery (77.5%), metastasectomy (17.5%) and radiosurgery and metastasectomy (5%). After agressive treatment objective response rate was 82.5%. At the median follow-up of 16.5 months, the median PFS and OS intervals were 15.5 (95% CI 9.3-21.7) and 21.9 (95% CI 13.5-30.2) months, respectively.
Conclusion:
Radically aggressive treatment for both the primary tumor and the metastases is reasonable and effective therapeutic option to provide long-term survival rates in selected patients with oligometastatic NSCLC. Further studies are needed, preferably prospective and randomized that analyze the efficacy and safety of aggressive ablative treatment for these patients.
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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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P2.02-073a - Does the PD-L1 Status and TIL Intensity Change in NSCLC and Syncronous Brain Metastases? (ID 10118)
09:30 - 09:30 | Author(s): R. Rzazade
- Abstract
Background:
Programmed death-ligand 1(PD-L1) expression in Non-small Cell Lung Carcinoma (NSCLC) is tissue based predictive marker. However, the differential expression of PD-L1 in tumor microenvironment between synchronous primary tumor in lung and metastatic side, especially brain metastasis remains unclear. This study addresses whether there is concordance of PD-L1 status and tumor infiltrating lymphocytes (TIL) together with intensity of CD8 lymphocytes, between the synchronous primary tumor and brain metastasis.
Method:
PD-L1 expression was evaluated immunohistochemically in primary lung tumor and synchronous brain metastasis by using the Dako PD-L1 IHC 22C3 pharmDx kit (SK006) . TIL were scored via CD3 and CD8 positivity immunohistochemically. PD-L1 expression was also compared with TIL proportion and intensity of CD8 lymphocytes between paired tumor tissues. All brain metastatic tissues had been removed before any treatment therefore;the study allowed the comparison of lung carcinoma and their native brain metastasis (BM).PD-L1 scoring was categorized based on the proportion of membranous immuno-positive tumor cells using cutoff values 0-1%, 1-49% and 50%. CD3 and CD8 positivity in TIL was evaluated semi quantitatively. Spearman rank correlation test was used for statistical analysis.
Result:
Primary tumor tissues and synchronous brain metastases of 24 NSCLC cases were included the study. Histopathological suptype of the cases were17/24 (70.83 % ) adenocarcinomas and 2/24 squamous cell carcinoma (8.3%), 1/24 adeno-squamous Ca.(4.16%) and 4/24 large cell carcinomas and pleomorphic carcinomas (16.6%). Tumor subtypes were the same in both primary tumor and BM specimen. In primary tumors, PD-L1 positivity was observed in 25% (6/24), 37.5% (9/24) and 37.5% (9/24) using cutoff values 0-1% , 1-49% and 50% respectively. PD-L1expresion score and pattern showed significant correlation in paired BM (Spearman rho= .731,p ˂0.001). However the PD-L1 expression on TIL cells and proportion of TIL infiltration was not demonstrated same concordance (Spearman rho= .548, p=0.006). When CD8 lyhmpocyte intensity among the TIL cells was compared between primary tumor and BM, only 54.16% (13/24) of the pair tumors were compatible.
Conclusion:
This study demonstrates that the concordance of PD-L1 expression between primary NSCLC and BM is very high. Thus, evaluation of PD-L1 in either primary lung tumors or brain metastasis would be useful for choosing anti PD-1/PD-L1 immunotherapy in patient with NSCLC with BM. Due to the low compatibility of CD8 intensity in TIL cells, may not be sufficient enough as a therapeutic target to use for both primary and brain metastases. Further research on this subject is required to gain deeper insigth in to the mecanism/biology of CD8 lymhpocites intensity in TIL cells and PD-L1 expression in NSCLC.
