Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
having COPD, 48.4% underwent spirometry. 30.2% of individuals with lung
cancer were also diagnosed with COPD and 60.8% underwent spirometry
at any time. Among those with a diagnosis of both lung cancer and COPD,
73.6% underwent spirometry. For individuals with registry recorded stage
data, 12,110 persons had stage I-II lung cancer, of whom 90.7% had spirometry
and 55.9% had a diagnosis of COPD. Conversely, among 31,392 persons with
stage III-IV lung cancer, 54.6% had spirometry and 46% were diagnosed with
COPD (p1.305 or the
exhaled nitric oxide at the end of radiotherapy>19.5ppbs was found to have a
closely relation with radiation pneumonitis.
Keywords: Radiation pneumonitis, radiation oncoloty, exhaled Nitric Oxide
MA05: INNOVATIVE TECHNIQUES IN PULMONOLOGY AND THE IMPACT ON LUNG CANCER
MONDAY, DECEMBER 5, 2016 - 16:00-17:30
MA05.07 IDENTIFYING COMORBID DISEASE ON CHEST CT SCANS
IN A LUNG CANCER SCREENING-ELIGIBLE COHORT
Elizabeth Regan 1 , Barry Make 1 , Gregory Kinney 2 , Matthew Budoff 3 ,
Debra Dyer 1 , Jeffrey Curtis 4 , Russell Bowler 1 , Meilan Han 4 , Terri Beaty 5 ,
John Hokanson 6 , Elizabeth Kern 1 , David Lynch 1 , Edwin Van Beek 7 , Edwin
Silverman 8 , James Crapo 1 , James Finigan 9
1 Medicine, National Jewish Health, Denver/United States of America, 2 University
of Colorado Denver, Aurora/CO/United States of America, 3 Los Angeles Biomedical
Research Institute, Torrance/CA/United States of America, 4 University of Michigan
Health System, Ann Arbor/United States of America, 5 Johns Hopkins Bloomberg
School of Public Health, Baltimore/MD/United States of America, 6 Epidemiology,
Colorado School of Public Health, Aurora/CO/United States of America, 7 Clinical
Radiology, Queen’s Medical Research Institute - University of Edinburgh,
Edinburgh/United Kingdom, 8 Brigham and Women’s Hospital, Boston/MA/United
States of America, 9 Medicine, National Jewish Health, Denver/CO/United States of
America
Background: Lung cancer screening (LCS) with chest CT scans in high-risk
smokers has been demonstrated to save lives. Medicare and private insurers
now cover these scans for beneficiaries under specific criteria. However,
most smokers will die of comorbid smoking-related diseases rather than lung
cancer itself. Important information about comorbid conditions is available
on screening chest CT scans, but the prevalence of these comorbidities
has not been comprehensively assessed. Methods: COPDGene subjects
from the Phase 1 visit who met USPSTF criteria for LCS (age > 55, >30 pack
years smoking, current or former smokers within 15 years of smoking
cessation or current smokers) were assessed for coronary calcification,
emphysema, gas trapping, airway wall thickening and vertebral bone density
on standard dose CT scans. A new diagnosis of emphysema, osteoporosis,
or cardiovascular disease was assumed when there was no self-report of
diagnosis or medication use. Results: In 76% of CT scans from LCS-eligible
COPDGene subjects, we found abnormal emphysema (>5% low attenuation
area @-950 Hounsfield units), airway wall thickening or gas trapping (>20%
low attenuation area @-856 Hounsfield units). Osteoporosis was identified
in 54% of all CT scans, and abnormal coronary artery calcium was present in
51%. In non-COPD smokers a new diagnosis of emphysema, osteoporosis or
coronary calcification was found in 741 (48%) subjects. Overall, 75% of LCS
eligible CT scans showed one or more non-cancer diagnoses. Conclusion:
Enhanced readings of the lung cancer screening scans could identify
individuals with previously undiagnosed osteoporosis, atherosclerotic heart
disease, emphysema and COPD. Identification and treatment for these
conditions may reduce morbidity and mortality, improve quality of life and
enhance smoking cessation.
Keywords: Screening, emphysema, coronary artery disease, osteoporosis
MA05: INNOVATIVE TECHNIQUES IN PULMONOLOGY AND THE IMPACT ON LUNG CANCER
MONDAY, DECEMBER 5, 2016 - 16:00-17:30
MA05.10 CELL-FREE DNA TESTING FOR EGFR MUTATIONS IN
CLINICAL PRACTICE - FACTS AND FIGURES FROM AN AUSTRIAN
LUNG CANCER CENTER
David Lang 1 , Elmar Brehm 1 , Thomas Gitter 2 , Christian Paar 3 , Jörg Berg 3 , Bernd
Lamprecht 1
1 Department of Pulmonology, Kepler University Hospital, Linz/Austria, 2 Central
Radiology Institute, Kepler University Hospital, Linz/Austria, 3 Institute of Medical
and Chemical Laboratory Diagnostics, Kepler University Hospital, Linz/Austria
Background: Detection of EGFR mutations using cell-free DNA in plasma
has recently emerged as a novel diagnostic approach to lung carcinoma. This
“liquid biopsy” (LB) may also be useful for monitoring disease activity in
EGFR-mutated tumors as well as in the management of EGFR-tyrosine kinase
inhibitor (TKI) therapy. We present data collected in one year of use and
report on applicability and diagnostic value in daily clinical practice. Methods:
EGFR Mutations were analyzed using the semi-quantitative Roche cobas®
EGFR Mutation Test v2, comprising 42 mutations. Cell free DNA was extracted
from EDTA-Blood with the Qiagen QIAsymphony circulating DNA Kit. LB was
initially used for follow-up of known EGFR-mutated tumors and/or in patients
under TKI-therapy. Subsequently, we introduced routine LB testing in the
primary diagnostic workup of lung cancer patients. Results: From July 2015 to
June 2016 we performed a total of 92 liquid biopsies in 77 patients (60% male,
mean age 65y) in whom EGFR mutations could be detected in 10 cases (13%).
EGFR status from histological samples was available in 40 patients, in 14 (18%)
of them mutations were reported. Compared to histological EGFR status, LB
reached a sensitivity and specificity of 0.57 and 0.96, respectively. A total of 9
patients had multiple LB testing during follow-up. Three of them initially had
detectable mutations by LB, which turned undetectable upon tumor-specific
treatment. Two patients remained EGFR-positive during follow-up despite
of therapy, whereas four patients remained negative throughout follow-up
and therapy. Resistance mutations under TKI-therapy were not observed.
Primary LB (before initiation of any tumor-specific therapy) was obtained
from 47 patients (72% male, mean age 66y). EGFR mutations by LB were
detected in 2 patients (4%; 1 Ins. Exon-20, 1 L858R), while histology revealed
EGFR mutations in 2 out of 22 patients (9%; both L858R). Comparison yielded
a sensitivity of 0.5 and a specificity of 0.95 for LB. Conclusion: Testing for
EGFR mutations using cell-free DNA has been established as a new powerful
tool in the field of pulmonary oncology. Apart from sole detection of EGFR
mutations, especially the application of LB in following patients over time will
provide valuable new opportunities in clinical routine and decision making
Keywords: liquid biopsy, EGFR mutation, follow-up, TKI
MA05: INNOVATIVE TECHNIQUES IN PULMONOLOGY AND THE IMPACT ON LUNG CANCER
MONDAY, DECEMBER 5, 2016 - 16:00-17:30
MA05: INNOVATIVE TECHNIQUES IN PULMONOLOGY AND THE IMPACT ON LUNG CANCER
MONDAY, DECEMBER 5, 2016 - 16:00-17:30
MA05.09 THERE IS A CLOSELY RELATION BETWEEN EXHALED
NITRIC OXIDE AND RADIATION PNEUMONITIS
Jiancheng Li 1 , Xiaobin Fu 2
1 Department of Radiation Oncology, Fujian Cancer Hospital, Fuzhou,fujian/China,
2 Fujian Medical University, Fuzhou/China
Background: Radiation pneumonitis is a major toxicity after the thoracic
radiotherapy, with no method available to accurately predict the individual
risk. This was a prospective study to evaluate the exhaled nitric oxide as a
predictive biomarker for radiation pneumonitis in the patients received the
thoracic radiotherapy Methods: A total of 68 patients with lung cancer or
MA05.11 PHOTODYNAMIC THERAPY FOR PERIPHERAL LUNG
CANCER USING COMPOSITE-TYPE OPTICAL FIBERSCOPE OF 1.0 MM
IN DIAMETER
Jitsuo Usuda, Tatsuya Inoue, Takayuki Ibi, Kenta Hasumi
Division of Thoracic Surgery, Nippon Medical School, Tokyo/Japan
Background: Photodynanic therapy (PDT), is a treatment modality for many
cancers, and uses a tumor-specific photosensitizer and laser irradiation. PDT
is recommended as a treatment option for centrally located early lung cancer.
The detection of peripheral lung cancers is increasing, and stereotactic body
radiotherapy (SBRT) and percutaneous thermal ablation are emerging as
Copyright © 2016 by the International Association for the Study of Lung Cancer
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