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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4305 - Somatostatin receptor 2 expression and clinical significance in pulmonary lymphoepithelioma-like carcinoma

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Shuting Han

Citation

Annals of Oncology (2018) 29 (suppl_8): viii670-viii682. 10.1093/annonc/mdy304

Authors

S. Han1, J. Yeong2, C.X. Lim3, M. Ang1, W.T..D. Lim1, C.K. Toh1, Q.S. Ng1, D.S.W.S. Tan1, T.K.H. Lim2, J.H. Loh2, A. Tanako2, R. Kanesvaran1, W.L. Tan1, T. Rajasekaran1, W. Nei4, A. Jain1

Author affiliations

  • 1 Division Of Medical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 2 Department Of Pathology, Singapore General Hospital, 169608 - Singapore/SG
  • 3 Medical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 4 Division Of Radiation oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
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Resources

Abstract 4305

Background

Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare Epstein-Barr virus (EBV) associated cancer, histologically indistinguishable from nasopharyngeal carcinoma (NPC). Somatostatin receptor type 2 (SSTR2) is a bonafide theranostic target in neuroendocrine tumour. It is also demonstrably expressed in NPC, with autoradiography and positron emission tomography (PET). SSTR2 expression has not been reported in PLELC. In this study, we aimed to investigate SSTR2 expression and its co-localization with EBV positive PLELC cells using immunohistochemistry (IHC); and to investigate the clinical significance of SSTR2 in PLELC.

Methods

Clinical demographics including age, gender, TNM staging, EBV titre, smoking status, survival and treatment regime were collected. Archival formalin fixed, paraffin embedded (FFPE) tissue from patients diagnosed with PLELC between 2003 and 2016 at National Cancer Centre Singapore were retrieved and studied retrospectively. IHC staining for SSTR2 and Epstein-Barr encoding region in-situ hybridisation (EBER-ISH) were performed using a dual-staining technique.

Results

We report clinical data and dual staining from 20 PLELC patients. The median age at diagnosis was 56.5; 80% (16/20) of the patients were female; all non-smokers (except 3 with unknown status); 55% (11/20) of the patients had stage IV disease and the rest stage I-IIIB. High serum EBV titres were also noted in PLELC patients. Sixteen out of 20 patients (80%) stained positive for SSTR2 on IHC. SSTR2 expression co-localised with EBER positive cells. Nine out of 11 (82%) patients with stage IV PLELC stained positive for SSTR2 while 7 out of 9 (78%) stage I-III disease stained positive. Two year OS by SSTR2 status is 100% in SSTR2 negative and 65.2% (CI 35.1, 84.0) in SSTR2 positive patients, p = 0.467 by Log Rank Test. Two year OS by stage is 85.7% (CI 33.4, 85.7) for stage I-III and 63.6% (CI 29.7, 84.5) for stage IV disease, p = 0.014.

Conclusions

In PLELC, high levels of SSTR2 IHC expression is reported with co-localisation with EBV infected cells. A high proportion of stage IV patients have SSTR2 positive tumours. These patients have limited treatment options. This study opens up the possibility of using SSTR2 theranostics for these patients.

Clinical trial identification

Legal entity responsible for the study

National Cancer Centre Singapore.

Funding

National Cancer Centre Singapore Research Fund.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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