Hui-Zi Chen, MD, PhD, an assistant professor in the Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center—The James, discusses the use of rapid research autopsy in metastatic ultra-hypermutated interdigitating dendritic cell sarcoma (IDCS), an extremely rare cancer of dendritic origin that lacks a standardized treatment approach.

It was through rapid research autopsy that investigators were able to procure multiple metastatic tumor samples from a patient with metastatic ultra-hypermutated IDCS, a very rare cancer type, says Chen. What is also unique about this patient’s cancer, in addition to the rare histology, is that he had an ultra-high mutated phenotype and a very high tumor mutational burden. An analysis of tumor tissues revealed that the patient did not have classic drivers leading to this ultra-hypermutation. Investigators hypothesized that this hypermutation may have occurred through changes or mutations in the APOBEC, adds Chen.

The important takeaway from that particular study is that different mechanisms lead to ultra-hypermutation. The goal of the study was to see how this cancer evolved in response to the multiple therapies that the patient received and investigators were able to do that through this work, concludes Chen.

Videos

Hui-Zi Chen, MD, PhD, discusses the use of rapid research autopsy in metastatic ultra-hypermutated interdigitating dendritic cell sarcoma, an extremely rare cancer of dendritic origin that lacks a standardized treatment approach.

Dr. Chen on Rapid Research Autopsy in Rare Cancer

Hui-Zi Chen, MD, PhD, an assistant professor in the Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center—The James, discusses how the phase III IMpower133 trial has helped to propel the field of small-cell lung cancer (SCLC) forward.

The landmark, randomized phase III IMpower133 trial changed the treatment of patients with metastatic SCLC, says Chen. In the study, chemotherapy-naïve patients were treated with the PD-L1 inhibitor atezolizumab (Tecentriq) in combination with standard chemotherapy composed of carboplatin and etoposide compared with placebo, carboplatin, and etoposide. This was followed by a maintenance phase during which patients received either atezolizumab or placebo.

At a median follow-up of 13.9 months, the median overall survival was 12.3 months in the atezolizumab arm versus 10.3 months in the placebo arm (HR, 0.70; 95% CI, 0.54-0.91; 

 =.007). Although only a 2-month improvement was observed, it was determined to be statistically significant, says Chen. Furthermore, the median progression-free survival with atezolizumab versus the control was 5.2 months and 4.3 months, respectively (HR, 0.77; 95% CI, 0.62- 0.96; 

The results from the trial lead to the FDA approval of atezolizumab in combination with carboplatin and etoposide for the first-line treatment of patients with extensive-stage SCLC, making it a very important study, concludes Chen.

Hui-Zi Chen, MD, PhD, discusses how the IMpower133 trial has helped to propel the field of small-cell lung cancer forward.

Hui-Zi Chen, MD, PhD

Articles

Dr. Chen on Rapid Research Autopsy in Rare Cancer

Dr. Chen on the Impact of the Pivotal IMpower133 Trial on SCLC