Plenary Session 5：Update in Pulmonary Diseases
| Time (GMT+8) |
Topic | Speaker | Country / Region |
|---|---|---|---|
| 11:10-11:40 | Next generation sequencing for lung cancer in the era of precision therapy | Dr. Kuei-Pin Chung | Taiwan |
| Time (GMT+8) |
Topic | Speaker | Country / Region |
| 11:40-12:10 | Current update of acute exacerbation in interstitial lung diseases | Dr. Toru Arai | Japan |
Next generation sequencing for lung cancer in the era of precision therapy
Abstract :
In East Asian population with lung adenocarcinoma, driver mutations in cancer cells can be detected in around 80% of the subjects, and are crucial genetic biomarkers for selecting personalized targeted therapy to prolong the survival. While EGFR mutations involving the coding of the kinase domain are the first driver mutations identified in the history, several driver mutations in lung adenocarcinoma have been discovered to date, and include single nucleotide mutations of KRAS and BRAF, fusion/rearrangement mutations of ALK, ROS1, NTRK1/2/3, and RET, and MET exon 14 skipping due to disrupted splicing mechanism. Although polymerase chain reactions, mass spectrometry, and immunohistochemistry staining, are applied in clinical laboratory for detecting driver mutations using tissue sections, these assay platforms only detect mutations of single gene. The development and maturation of next-generation sequencing (NGS) technology pave the avenue to comprehensive profiling of all potential druggable driver mutations of target genes with enhanced analytical sensitivity. Meanwhile, several recent studies have demonstrated that driver mutations can be successfully identified through sequencing circulating DNA fragments from tumor cells, and blood genotyping through NGS platform is an alternative diagnostic approach for detecting driver mutations, in particular when tissue biopsy is not feasible or tissue specimens are limited. This talk will focus on the history and the breakthrough of molecular diagnostics in clinical laboratory, and the clinical applications and implementations of NGS for identifying driver mutations in lung cancer.
Dr. Kuei-Pin Chung
Taiwan
Current update of acute exacerbation in interstitial lung diseases
Abstract :
Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown etiology with a poor prognosis. Kondoh et al. firstly reported three patients with IPF showing rapid deterioration in English literature (Chest 1993). Such cases of acute deterioration with unknown etiology are known as acute exacerbation (AE) of IPF (AE-IPF). From the experience of acute lethal IPF patients in clinical trial of interferon-γ, presence of AE-IPF in the clinical course of IPF was confirmed in countries other than Japan (Martinez, et al. Ann Intern Med 2005). Frequency of AE-IPF was 20-30% during the three years from the diagnosis of IPF and 90-day survival was 35 -70% (Arai T, J Clin Med 2023; Suzuki Respirology 2020). AE is now reported to occur in IIP patients other than IPF and in interstitial lung disease (ILDs) other than IPF according to the diagnostic criteria of AE-IPF. Frequency of AE in ILDs other than IPF is about half of that in IPF; however, prognosis of AE in ILDs other than IPF is similar to that of AE in ILDs other than IPF (Arai T, Respirology 2016; Suzuki, et al Respirology 2020).
Corticosteroid is usually used for AE-IPF and its effectiveness has not been proved sufficiently; however, we have evaluated its effect for AE-IIP patients, who did not need positive pressure ventilation within one month from the start of therapy (Arai T, et al. Respirology 2017). We have shown survival of AE-IIP patients treated with high dose prednisolone was better than that with low dose prednisolone. In addition, we have performed prospective clinical trial to show effectiveness of soluble thrombomodulin (rTM) (SETUP trial) and shown its usefulness; however, RCT of rTM following SETUP trial denied its effect.
We would like to show updated information about AE-ILD using recent literature and recent data of our institute.
Dr. Toru Arai
Japan
Graduated from School of Medicine, Osaka University, Japan
Received PhD from Graduate School of Medicine, Faculty of Medicine, Osaka University.
2000-present: Staff physician, Department of Respiratory Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center
2014-2022: Director, Department of Respiratory Failure, Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center
2023-present: Executive Director, Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center
Research focus
- Interstitial lung diseases (ILDs)
- Acute exacerbation of ILDs
- Rare lung diseases
3.1 Pulmonary alveolar proteinosis
3.2 Lymphangioleiomyomatosis
Dr. Pan-Chyr Yang
Taiwan
National Taiwan University College of Medicine and National Taiwan University Hospital, Institute of Biomedical Sciences, Genomics Research Center, Academia Sinica, Taiwan.
Dr. Hao-Chien Wang
Taiwan
Dr. Hao-Chien Wang is professor of Internal medicine in College of Medicine National Taiwan University and consultant physician in Chest specialty practicing at National Taiwan University Hospital in Taipei city.Dr. Wang has an outstanding career marked by contributions to academic research, education, training and clinical practice. Dr. Wang’s research focuses mainly on basic and clinical researches on obstructive airway diseases, acute lung injury and chest ultrasonography in diagnosing of pulmonary diseases. He has published more than 120 papers in national and international peer reviewed journals. Furthermore, Dr. Wang is an investigator for several ongoing global clinical studies in the area of respiratory disease including pneumonia, COPD & asthma.
