Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
POSTER SESSION 2 – P2.02: LOCALLY ADVANCED NSCLC
BIOLOGY –
TUESDAY, DECEMBER 6, 2016
P2.02-002 ASSOCIATION BETWEEN VEGF GENE FUNCTIONAL
POLYMORPHISMS AND CLINICAL AND PATHOLOGICAL
CHARACTERISTICS OF NON-SMALL CELL LUNG CANCER
Anna Shchayuk 1 , Evelina Krupnova 1 , Michael Shapetska 2 , Alena Mikhalenka 1 ,
Natalia Chebotaryova 1 , Svetlana Pissarchik 3
1 Institute of Genetics and Cytology, National Academy of Sciences of Belarus,
Minsk/Belarus, 2 Belarusian State Medical University, Minsk/Belarus, 3 City Clinical
Pathologoanatomic Bureau, Minsk/Belarus
Background: Vascular endothelial growth factor (VEGF) is one of the most
important angiogenic factor, which promotes endothelial cell growth and
tumor neovascularization. VEGF expression is a marker of invasiveness and
tumor progression in various cancers including in NSCLC. The aim of this study
was to analyze association between VEGF gene functional polymorphisms
and clinical and pathological characteristics of NSCLC. Methods: A total of
276 people with histological diagnosis of squamous cell carcinoma (SCC)
and adenocarcinoma (AC) were included in this study. All patients gave their
informed consent. VEGF gene polymorphisms were determined by PCR-RFLP
analysis. Statistical analysis of the material was carried out using SNPStats
online program. Results: Analysis of rs699947 polymorphism association with
clinical and pathological characteristics of the tumor showed that patients
with -2578CC genotype are more likely to have a greater extent of the primary
tumor (T2-T4) than a small non-invasive cancer (T1): p = 0.005; OR = 2.54, 95%
CI: 1.35-4.77. Association between this polymorphism and regional lymph
node metastasis and the stage of the disease was found. A-allele is protective
against a more aggressive course of the disease: in patients with -2578AA
genotype regional lymph node metastases (N1-3) occur less frequently as
compared to -2578CC genotype carriers (p = 0.0098; OR = 0.34, 95% CI: 0.17-
0.69). -2578A-allele carriers are less likely to have stages of the disease III and
IV (p = 0.012 and 0.015 respectively). A tendency of rs3025039 polymorphism
influence on the histological type of the tumor was identified. + 936TT
genotype is more common in patients with SCC as compared to AC (p = 0.055;
OR = 4.78, 95% CI: 1.01-22.71). For rs2010963 polymorphism the association
with clinical and pathological characteristics of NSCLC was not identified.
Haplotype analysis of three studied polymorphisms of VEGF gene showed a
significant association between -634C/-2578C/+936C haplotype and a small
non-invasive cancer (p = 0.0068). -634G/-2578C/+936C haplotype carriers
showed high aggressiveness of the disease (stage - p = 0.0061; regional lymph
node metastasis - p= 0.0014). Conclusion: -2578CC genotype of rs699947
polymorphism VEGF gene is associated with a large size of the primary tumor
focus, the occurrence of regional lymph node metastasis and a greater stage
of the disease. High aggressiveness of the disease was revealed in -634G/-
2578C/+936C haplotype carriers. A significant association between -634C/-
2578C/+936C haplotype and small non-invasive cancer was showed.
Keywords: VEGF gene polymorfisms, vascular endothelial growth factor, nonsmall
cell lung cancer, angiogenesis
POSTER SESSION 2 – P2.02: LOCALLY ADVANCED NSCLC
BIOLOGY –
TUESDAY, DECEMBER 6, 2016
P2.02-003 INCREASED CIRCULATING CYTOKERATIN-19 (CYFRA
21-1) IS PREDICTIVE OF POOR OUTCOME OF LOCALLY ADVANCED
SQUAMOUS CELL CARCINOMA IN LUNG
Jingbo Wang 1 , Zhe Ji 1 , Jianzhong Cao 2 , Yan Ma 3 , Wei Jiang 1 , Lipin Liu 1 , Yu Men 1 ,
Cai Xu 1 , Xiaozhen Wang 1 , Zhou Guang Hui 1 , Jun Liang 1 , Jima Lv 1 , Zongmei Zhou 1 ,
Zefen Xiao 1 , Qinfu Feng 1 , Dongfu Chen 1 , Hongxing Zhang 1 , Weibo Yin 1 , Luhua
Wang 1
1 Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences,
Beijing/China, 2 Cancer Hospital of Shanxi Cancer Hospital, Taiyuan/China,
3 Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing/China
Background: Our goal was to evaluate the prognostic significance of
circulating tumour markers in locally advanced squamous cell carcinoma of
lung (LA-SCCL). Methods: Eligible patients included those with histologically
proven LA-SCCL, available baseline tumour marker panel analysis (carcinoembryonic
antigen [CEA], carcinoma antigen 125 [CA125], squamous cell
carcinoma antigen [SCC], cytokeratin-19 [Cyfra 21-1] and neuron-specific
enolase [NSE]) and receiving definitive radiotherapy. Age, gender, radiation
dose, baseline KPS, smoking history, weightless, TNM stage, PET staging,
RT technique and treatment modality (radiotherapy alone vs. sequential
chemoradiotherapy vs. concurrent chemoradiotherapy) were also
retrospectively collected. To dichotomise the continuous values of tumour
markers into categorical variables, ROC analysis was adopted to identify the
optimal cutoff values using the progression within 2 years after diagnosis as
the endpoint. Cox regression based multivariate analyses were used to select
independent factors correlated with various survival endpoints. Overall
survival (OS), local regional progression free survival (LRPFS) and distant
metastasis free survival (DMFS) were defined as the time from diagnosis
until the first occurrence of specific event: death, local-regional recurrence or
distant metastasis, respectively. Progression free survival (PFS) was defined
as the duration between the cancer diagnosis and the date of any progression
or cancer related death. Results: A total of 216 patients with LA-SCCL were
analyzed. The optimal discriminative values for CEA, CA125, SCC, Cyfra 21-1
and NSE in predicting 2-y progression were 5.3 ng/ml, 17.0 U/ml, 2.5 ng/ml,
5.2 ng/ml and 17.8 ng/ml, respectively. Univariate analyses showed that
increased Cyfra 21-1 was associated with inferior OS, LRPFS, DMFS and PFS.
Increased NSE was predictive of poor OS, DMFS and PFS. CEA also presented
significant correlation with OS. Under multivariate analysis involving all
clinical and tumour markers, IIIA stage, better performance status, CEA ≤
5.3 ng/ml and Cyfra 21-1 ≤ 5.2 ng/ml were independently associated with
improved OS. IMRT technique, RT dose ≥ 60Gy and Cyfra 21-1 ≤ 5.2 ng/ml were
correlated with better LRPFS. None-smoker, IIIA stage, NES ≤ 17.8 ng/ml were
favourable predictors for DMFS. IIIA stage, KPS ≥ 80 and Cyfra 21-1 ≤ 5.2 ng/ml
were advantageous factors related with favourable PFS. Conclusion: Baseline
tumour marker panel including Cyfra 21-1, NSE and CEA can be prognostic of
OS, local and distant tumor control for LA-SCCL, and should be recommended
for baseline evaluation of tumour burden.
Keywords: Non-small cell lung cancer, squamous cell carcinoma, serum tumor
marker, prognosis
POSTER SESSION 2 – P2.02: LOCALLY ADVANCED NSCLC
BIOLOGY –
TUESDAY, DECEMBER 6, 2016
P2.02-004 REAL-TIME MONITORING OF CIRCULATING
TUMOR CELLS TO EVALUATE RESPONSE OF NEOADJUVANT
CHEMOTHERAPY IN LOCALLY ADVANCED NSCLC
Miao Huang, Yuanyuan Ma, Yue Yang
Peking University Cancer Hospital and Institute, Beijing/China
Background: Enumeration and karyotyping of circulating tumor cells (CTCs)
in therapeutic cancer patients is of particular clinical significance. The aim
of this study is to evaluate therapeutic effect of neoadjuvant chemotherapy
(NAC) by means of real-time monitoring of CTCs in locally advanced nonsmall
cell lung cancer (NSCLC). Methods: Real-time monitoring of CTCs in the
course of 2 cycles of platinum-based NAC was conduct in 34 locally advanced
NSCLC patients. The integrated subtraction enrichment and immunostaining
fluorescence in situ hybridization (SE-iFISH) method was applied to detect
and characterize CTCs in peripheral venous blood. Chest CT was used to
evaluate therapeutic response with RECIST 1.1 as the evaluation criterion.
Results: Of the 34 patients enrolled, 13 acquired partial response (PR) and
21 were stable diseases (SD) after NAC. The numbers of CTCs were found
decrease in 70% of PR patients and only 25% of SD patients. The changes of
CTC count were significantly different between PR and SD group (p=0.009).
The positive rate of CTCs with triploidy of chromosome 8 increased after 2
cycles platinum-based NAC, and the elevation was even more remarkable in
SD group. Conclusion: The changes of CTC count after NAC were in accordance
with CT responses. Triploidy of chromosome 8 CTC was correlated with
primary resistance to platinum-based chemotherapy. Real-time monitoring
of CTC count and karyotype may be of clinical value in rapid evaluation of
therapeutic effect and monitoring occurrence of chemo-resistance.
Keywords: non-small cell lung cancer, neoadjuvant chemotherapy, Circulating
tumor cell, Therapeutic response
POSTER SESSION 2 – P2.02: LOCALLY ADVANCED NSCLC
BIOLOGY –
TUESDAY, DECEMBER 6, 2016
P2.02-005 A RARE CLINICAL PRESENTATION OF EGFR-MUTANT
NON-SMALL CELL LUNG CANCER WITH OLIGO-ACROMETASTASIS
Pınar Akın Kabalak 1 , Tuba Inal Cengiz 1 , Ugur Yılmaz 1 , Derya Kızılgöz 1 , Metehan
Karaca 2 , Fatma Canbay 1 , Inci Uslu 3 , Yetkin Ağaçkıran 4 , Kyle Wang 5
1 Chest Disease, Ankara Atatürk Chest Disease and Thoracic Surgery Training and
Research Hospital, Ankara/Turkey, 2 Radiation Oncology, Ankara Atatürk Chest
Disease and Thoracic Surgery Training and Research Hospital, Ankara/Turkey,
3 Nuclear Medicine, Ankara Atatürk Chest Disease and Thoracic Surgery Training and
Research Hospital, Ankara/Turkey, 4 Ankara Atatürk Training and Research Hospital,
Ankara/Turkey, 5 Radiation Oncology, University of North Carolina Hospitals,
Chapel Hill/NC/United States of America
Background: 44% of acrometastasis are originated from primary lung tumors
and metastasis to digits is seen in 0.2% of patients with lung cancer. After
Copyright © 2016 by the International Association for the Study of Lung Cancer
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