Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Clinical, pathological and molecular characterization of long-term survivors with advanced non-small cell lung cancer in a multicenter experience in Madrid: Final results.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20621)
Author(s): Juan Moreno, Santiago Ponce Aix, Rosa Maria Alvarez Alvarez, Maria Eugenia Olmedo Garcia, Sandra Falagan, Xabier Mielgo, FÃ¡tima Navarro, Patricia Cruz, Luis Cabezon-Gutierrez, Marta Muñoz Fernandez de Legaria, Ana Belen Enguita, Maria Cebollero, Amparo Benito, Isabel Alemany, Carolina Castillo Torres, Ana Ramirez de Molina, Enrique Casado, Ricardo Ramos, Gonzalo Colmenarejo, Maria Sereno Moyano; Molecular Oncology Group, IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Gregorio Marañon Hospital, Madrid, Spain; Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain; Medical Oncology Department, Infanta Sofía University Hospital, San Sebastián De Los Reyes, Spain; Hospital Fundación Alcorcon, Alcorcon, Spain; Hospital Príncipe de Asturas, Alcalá De Henares, Spain; Hospital Universitario La Paz, Madrid, Spain; Hospital Universitario de Torrejon Calle Mateo Inurria S/N, Torrejón De Ardoz, Madrid, Spain; Infanta Sofía University Hospital, San Sebastián De Los Reyes, Spain; Instituto de Investigacion Sanitaria Gregorio Marañon, Madrid, Spain; Pathology Department, Ramón y Cajal University Hospital,, Madrid, Spain; Hospital Príncipe de Asturias, Alcalá De Henares, Spain; Molecular Oncology Group, IMDEA Food Institute, CEI UAM, CSIC, Madrid, Spain; Medical Oncology Department, Infanta Sofía University Hospital, Madrid, Spain; Parque Científico de Madrid, Madrid, Spain; Biostatistics and Bioinformatics Unit, IMDEA-Food Institute, CEI UAM, CSIC, Madrid, Spain
Background: Long survivors (LS) in non-small-cell lung cancer (NSCLC), defined as an overall survival (OS) greater than 2 years, are less than 10% in most series. Classical prognosis factors include stage, weight loss and ECOG, but more information is missing in the literature. Recently, EGFR, ALK and ROS 1 population (less than 20%) reach OS longer than 2 years. Immunotherapy has demonstrated very promising results with more LS compared to chemotherapy in first and second line setting. In this study, we focused in the analysis of LS patients with advanced NSCLC EGFR wt (wild type) and ALK nt (non-translocated), defined as those with OS greater than 36 months, in 7 hospitals in Madrid. Methods: In this serie, first of all, we will try to make a clinical, histopathological characterization collecting data from clinical reports according to a previously defined information. In a second step, we will carry out a genetic analysis of these patient samples comparing to an opposite extreme short survivors (SS) samples (OS less than 9 months). Initially, we used a NGS method of RNA-seq technology to identify differentiating profiles of gene expression between the two opposite populations. And finally, we confirmed this preliminary profile by RT-PCR in the rest of samples. Results: Ninety-six patients were initially included. The majority were men, smokers or former with adenocarcinoma and ECOG 0- 1. We have obtained a differential transcriptome expression between samples from 6 LS and 6 SS, resulting 13 over-expressed and 42 down-expressed genes in LS comparing to SS transcriptome expression. Some of the genes involved in this initial profile belong to different cellular pathways: Secretin Receptor, Surfactant Protein, Trefoil Factor 1, Serpin Family, Ca-bindings Protein channel and Toll like Receptor family. Finally, we carried on by RT-PCR in 40 samples of SS and LS survivors and only four genes were significantly down-regulated in SS compared to LS in the multivariate analysis. These 4 genes were related to Surfactant Proteins: SFTPA1 (p = 0.023), SFTPA2 (p = 0.027), SFTPB (p = 0.02) and SFTPC (p = 0.047). Conclusions: We present a sequential genetic analysis of a LS population with NSCLC EGFR wt (wild type) and ALK nt (non-translocated), obtaining a differential RNA seq- and RT-PCR gene profile based on different surfactant proteins expression. A further confirmation in a larger sample is ongoing.