ASCO 2015

Preliminary analysis on the RNA sequencing data of lung squamous cell carcinoma

Prof Yilong Wu - President of the Chinese Society of Clinical Oncology

China has quite a lot of experience with EGFR inhibitors in lung cancer therapy. Can you tell me what you were trying to do in this study that you are presenting here at ASCO?

As you know, in China the EGFR mutation ... Europe or in the US countries now about 50% of female patients have the EGFR mutation in patients. So this is a very, very severe problem in China, also global, if you have the EGFR mutation present. In the clinical practice EGFR mutation patients, we give the patient the EGFR inhibitor but generally after ten months or eleven months then the patients develops resistance and failure to the treatment.

So when you get resistance to an EGFR TKI what are your options, because you have got a new possibility, haven’t you?

Yes, so now we find EGFR TKI, now we have two mechanisms for why the patients failure to the EGFR. One is the second mutation that in this congress there are so many reports about, again, the second mutation. The second is another gene, this gene means c-Met. So that is c-Met amplified.

What did you do in the study looking at c-Met inhibition?

So we found in the c-Met amplified about 20% patients in the EGFR TKIs. So we used one drug, this drug is named crizotinib. So crizotinib is the target and c-Met. So we are using this drug to overcome the EGFR TKI when the patient is c-Met positive.

Now you’ve looked at about a hundred patients, what have you found up to now?

Up to now we find about a patient positive treated with crizotinib, we find about 50% of patients have a response to this drug. So it’s very exciting, the result.

What, then, are the clinical implications for cancer doctors?

In the clinical practice if you find the patient resistant to EGFR TKI you need to test what happens in this patient. So if the patient tests c-Met positive you can try the crizotinib to overcome this resistance.

So you’ve got a clear molecular marker?

Yes, it’s a very clear molecular profile. So in the US or Europe where you like using FSH to test the c-Met inhibitor but my work in China using another method, this means. It's very easy to detect c-Met overexpression. So if the c-Met is strong positive you can use crizotinib to overcome the resistance.

So could you sum up what doctors should take away from your findings?

I recommend doctors in clinical practice, if the patient develops resistance to EGFR TKI you need to test the c-Met. If the c-Met is positive you can use crizotinib to overcome.