- Email: [email protected]
P1.12-001 Flexible Bronchoscopic Cryotherapy in Patients with Malignant Central Airway Obstruction
November 2017 G719X EGFR mutation under EGFR-TKI were 4 partial response, 5 stable disease, 1 progressive disease, and 3 patients were unevaluable (the response rate of 33.3% and the control rate of 75%). In 19 stage IV non-squamous NSCLC patients under EGFR-TKI, the EGFR mutated patients had longer OS than the wild type or unknown status (median OS of 36, 3, 22 weeks in EGFR mutated, wild type, and unknown status, p¼0.018). Conclusion: Histology, staging, and ECOG PS had statistical significance affecting OS of nonagenarian patients. The lower SCS score patients had insignificant longer OS. The stage IV EGFR mutated non-squamous NSCLC patients under EGFRTKI had longer OS than wild type or unknown status. Majority of nonagenarian patients could receive first line treatment, and it is important to find out the appropriate treatment for the “fit” patient. Keywords: lung cancer, elderly, Nonagenarian
P1.11-003 A Personalized Navigation Program to Increase Clinical Trial Participation of Lung Cancer Patients A. Ciupek,1 T. Perloff,1 J. King2 1Science and Research, Lung Cancer Alliance, Washington, DC/US, 2Science & Research, Lung Cancer Alliance, Washington, DC/US Background: Only three to five percent of newly diagnosed cancer patients participate in clinical trials (Lara PN, 2001). We previously conducted a survey of U.S. lung cancer patients and found only 22% reported discussing clinical trial participation with their oncologist at the time of making treatment decisions (Fenton L, 2009). We hypothesized that a personalized navigation program could increase the amount of lung cancer patients initiating trial conversations with their oncologists and ultimately trial participation. Here we describe initial results from a pilot program, offering personalized, telephone-based clinical trial support to lung cancer patients. Method: Callers to Lung Cancer Alliance’s 1-800 support line between 8/1/2016 and 6/7/2017 were asked if they had considered clinical trial participation and willing callers were referred to a clinical trial navigator for further discussion about clinical trial options. Navigators provided basic clinical trial education and a personalized list of clinical trial matches based on discussion. Patients were encouraged to discuss these trials with their treating oncologist. Navigators then regularly followed up with participants, via email or phone, at two to four week intervals, to offer further support and collect outcomes information. Result: 36 callers were referred to a navigator during the pilot. Subsequently, 23 patients (64%) reported discussing clinical trials with their oncologist. Six of these approached a specific trial, with one enrolling, four being excluded due to not meeting eligibility criteria, and one not enrolling due to the trial being closed. Three others choose standard of care treatment over trials and one declined treatment. Two had doctors advise against trials in favor of other options. Three had disease progression preventing further trial consideration and one passed away. Seven of the 23 were still discussing trials at the end of follow up. Six of the initially referred callers chose not to discuss trials with their oncologist. The majority of these (five) reported not feeling a need to discuss trials due to having stable disease on a current treatment. The remaining caller reported feeling a lack of doctor support as reason for choosing not to discuss. Seven of the 36 initial callers were lost to follow-up. Conclusion: Given that 64% of the patients in the pilot program reported discussing trials with their oncologist, a personalized support program may represent an effective means of increasing clinical trial participation among lung cancer patients. This program will be expanded to include more participants and gather more information on barriers to clinical trial participation. Keywords: clinical trials, lung cancer, patient navigation
Abstracts
S2027
P1.11-004 Impact of Liquid Biopsy on the Treatment of LowIncome Lung Cancer Patients A. D’Souza,1 C. Brooks,2 G. In,1 V. Raymond,2 R. Lanman,2 J. Nieva1 1 Oncology, USC Norris Comprehensive Cancer Center, Los Angeles, CA/US, 2 Guardant Health, Redwood City/US Background: A number of patients with lung cancer receive their oncologic care at safety net hospitals that primarily treat low-income patients. These hospitals lack resources for rapid tissue biopsy and do not routinely offer liquid biopsies. Up to 25% of patients with nonsmall cell lung cancer (NSCLC) have insufficient tissue recovered on biopsy for genotyping. Guardant360 is a non-invasive cell-free circulating tumor DNA (cfDNA) test providing comprehensive genomic profiling of genes recommended by the National Comprehensive Cancer Network (NCCN). Method: We enacted a program at Los Angeles County-USC Medical Center aimed at increasing patient access to Guardant360. For testing costs, qualified patients were enrolled in the testing company’s financial assistance program, subject to meeting financial eligibility criteria. Additionally, patients had access to a mobile phlebotomy service. We identified patients with metastatic NSCLC who had undergone Guardant360 testing between August 2016 and February 2017. Medical records were reviewed for results of molecular testing (tissue and cfDNA) and the impact of Guardant360 on clinical decision-making. We also reviewed tissuebased testing for EGFR mutations and ALK rearrangements ordered at Los Angeles County-USC Medical Center on 664 patients with lung cancer from 2005 to 2015. Result: Guardant360 testing was sent on 10 patients with NSCLC, 9 with adenocarcinoma and one with squamous histology. Seven had somatic mutations on cfDNA analysis with 3 of these seven patients having a targetable mutation, as defined by NCCN. Tissue was sent for molecular testing on 5 of the 10 patients with four patients having cfDNA results concordant with tissue results. For the remaining five patients, there was either insufficient tissue for testing (N¼3) or testing was not ordered (N¼2). In this cohort of uninformative tissue results, cfDNA results found one patient with an ALK rearrangement, one patient with a KRAS mutation, and no targetable mutations in three patients. The patient with ALK rearrangement had therapy changed based on Guardant360 results. On review of tissuebased testing for 664 patients, ordered at Los Angeles County-USC Medical Center, there were no ALK and EGFR testing results available for 79% and 75.8% of patients, respectively. Conclusion: Liquid-based biopsies can be useful in identifying patients with targetable mutations. Implementation of programs that give patients access to liquid biopsy in resource-limited environments, in which over 75% had incomplete tissue results, has the potential to impact care. This data highlights the potential benefit of liquid biopsy and illustrates how this program leads to changes in therapy for some patients. Keywords: liquid biopsy, low-income
P1.12-001 Flexible Bronchoscopic Cryotherapy in Patients with Malignant Central Airway Obstruction S.K. Kim, Y.M. Ko, S.Y. Kim, S.H. Song, C.H. Kim Department of Internal Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon/KR Background: Although malignant central airway obstruction has poor prognosis, cryotherapy can be used as a palliative treatment. The objective of this study is to evaluate the role of flexible bronchoscopic cryotherapy in patients with malignant central airway obstruction.
S2028 Method: Clinical data of patients who performed flexible bronchoscopic cryotherapy for recanalization of malignant central airway obstruction from March 2014 to September 2016 were analyzed retrospectively. Result: 29 patients (21 males) were enrolled. Median age was of 65 years (range, 54-82) and median ECOG performance status was 3 (range, 1-3). Causes of malignant central airway obstruction were primary lung cancer of 21 cases (Squamous cell carcinoma, 12 cases; small cell carcinoma, 9 cases) and endobronchial metastasis of 8 cases (soft tissue sarcoma, 2 cases; renal cell cancer, 4 cases; glottis cancer, 1 case; endometrial cancer, 1 case). Obstruction sites were as follows: carina and both main bronchus, 4 cases; left main bronchus, 9 cases; right main bronchus, 8 cases; bronchus intermedius, 8 cases. Degree of obstruction was classified into three categories: complete, 6 cases; partial non-passable with scope, 5 cases; partial passable with scope, 18 cases. Type of obstruction was classified into two types: intrinsic obstruction, 8 cases (all endobronchial metastasis); extrinsic obstruction, 21 cases (all primary lung cancer). Complete recanalization was achieved in 8 cases (27.6%), and all of them were endobronchial metastasis. Partial recanalization was achieved 21 cases (72.4%). Dyspnea was improved in 23 patients (79.3%). There was no immediate complication, such as respiratory failure or massive bleeding. Conclusion: Cryotherapy with flexible bronchoscopy is a feasible and effective treatment for malignant central airway obstruction, especially due to endobronchial metastasis. For more clarification, further prospective study of large scale will be required. Keywords: cryotherapy, lung cancer, Airway obstruction
Journal of Thoracic Oncology
Vol. 12 No. 11S2
of advanced lung cancer. Method: The frequency of FOLR1 expression in primary lung cancer and metastatic lymph nodes was first analyzed by human tissue samples from surgery and endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA). Confocal fluorescence microscopy was then used to confirm the cellular uptake and fluorescence activation in lung cancer cells, and the photocytotoxicity was evaluated using a cell viability assay. In vivo fluorescence activation and quantification of uptake were investigated in mouse lung orthotopic tumor models, followed by the evaluation of in vivo PDT efficacy. Result: FOLR1 was highly expressed in metastatic lymph node samples from patients with advanced lung cancer and was mainly expressed in lung adenocarcinomas in primary lung cancer. Expression of FOLR1 in lung cancer cell lines corresponded with the intracellular uptake of folate-porphysomes in vitro. When irradiated with a 671 nm laser at a dose of 10 J/cm2, folateporphysomes showed marked therapeutic efficacy compared with untargeted porphysomes (28% vs. 83% and 24% vs. 99% cell viability in A549 and SBC5 lung cancer cells, respectively. Systemically-administered folate-porphysomes accumulated in lung tumors with significantly enhanced disease-to-normal tissue contrast. Folate-porphysomes mediated PDT successfully inhibited tumor cell proliferation and activated tumor cell apoptosis. Conclusion: Folate-porphysome based PDT shows promise in selectively ablating lung cancer based on FOLR1 expression in these preclinical models. Keywords: folate receptor 1 (FOLR1), lung cancer, photodynamic therapy (PDT)
P1.12-003 Photothermal Ablation of Lung Cancer by Low Power Near-Infrared Laser and Topical Injection of Indocyanine Green; A Preliminary Animal Study K. Hirohashi,1 T. Anayama,1 H. Wada,2 T. Kato,2 K. Orihashi,1 K. Yasufuku2 1Thoracic Surgery, Kochi Medical School, Kochi University, Nankoku/JP, 2Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON/CA
P1.12-002 Nanoparticle Targeted Folate Receptor 1 Enhanced Photodynamic Therapy for Lung Cancer T. Kato,1 C. Jin,2 H. Ujiie,1 D. Lee,1 F. Kosuke,1 H. Wada,1 H. Hu,1 R. Weersink,3 J. Chen,4 M. Kaji,5 B. Wilson,4 G. Zheng,4 K. Kaga,6 Y. Matsui,6 K. Yasufuku1 1Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON/CA, 2Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto/CA, 3Techna Institute, Princess Margaret Cancer Center, University Health Network, Toronto/CA, 4Department of Medical Biophysics, University of Toronto, Toronto/CA, 5Department of Thoracic Surgery, Sapporo Minami-Sanjo Hospital, Sapporo/JP, 6 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo/JP Background: Despite modest improvements, the prognosis of lung cancer patients has still remained poor and new treatment is urgently needed. Photodynamic therapy (PDT), the use of light-activated compounds (photosensitizers) is a treatment option but its use has been restricted to central airway lesions. Here, we report the use of novel porphyrin-lipid nanoparticles (porphysomes) targeted to folate receptor 1 (FOLR1) to enhance the efficacy and specificity of PDT that may translate into a minimally-invasive intervention for peripheral lung cancer and metastatic lymph nodes
Background: Surgical resection by lobectomy with systematic lymph node dissection is the gold standard of treatment for early stage non-small cell lung cancer. However, minimally invasive tumor ablation can be an alternative treatment for patients not eligible for surgery due to comorbidities. The present study was designed to evaluate the efficacy of photothermal ablation therapy for lung cancer by low power near-infrared laser and topical injection of Indocyanine green (ICG). Method: 6 New Zealand white rabbits were employed for the study. Tumor suspension containing VX2 cancer cells with growth factor reduced Matrigel was inoculated into the lung using an ultrathin bronchoscope. 3 rabbits were treated by laser ablation therapy with topical injection of ICG. Another 3 rabbits were treated by laser ablation alone. All tumors were irradiated with a laser with 500 mW output at 808 nm for 15 min. The tumors were examined histopathologically to assess the ablated areas. Result: The maximum surface temperature of the tumor in rabbits treated by ICG/laser and laser alone were more than 58 C and less than 40 C, respectively. The ablated areas in the rabbits using ICG/ laser were statistically larger than those in the rabbits using laser alone (ICG/laser: 0.49±0.27 cm2 vs laser alone: 0.02±0.002 cm2) (p <0.05). Conclusion: We clarified the efficacy of the photothermal treatment by low power near-infrared laser and topical injection of ICG using a rabbit VX2 orthotopic lung cancer model. This system may be able to be applied for transbronchial laser ablation of peripheral lung cancers. Keywords: Indocyanine green, near-infrared laser, photothermal ablation
P1.11-003 A Personalized Navigation Program to Increase Clinical Trial Participation of Lung Cancer Patients A. Ciupek,1 T. Perloff,1 J. King2 1Science and Research, Lung Cancer Alliance, Washington, DC/US, 2Science & Research, Lung Cancer Alliance, Washington, DC/US Background: Only three to five percent of newly diagnosed cancer patients participate in clinical trials (Lara PN, 2001). We previously conducted a survey of U.S. lung cancer patients and found only 22% reported discussing clinical trial participation with their oncologist at the time of making treatment decisions (Fenton L, 2009). We hypothesized that a personalized navigation program could increase the amount of lung cancer patients initiating trial conversations with their oncologists and ultimately trial participation. Here we describe initial results from a pilot program, offering personalized, telephone-based clinical trial support to lung cancer patients. Method: Callers to Lung Cancer Alliance’s 1-800 support line between 8/1/2016 and 6/7/2017 were asked if they had considered clinical trial participation and willing callers were referred to a clinical trial navigator for further discussion about clinical trial options. Navigators provided basic clinical trial education and a personalized list of clinical trial matches based on discussion. Patients were encouraged to discuss these trials with their treating oncologist. Navigators then regularly followed up with participants, via email or phone, at two to four week intervals, to offer further support and collect outcomes information. Result: 36 callers were referred to a navigator during the pilot. Subsequently, 23 patients (64%) reported discussing clinical trials with their oncologist. Six of these approached a specific trial, with one enrolling, four being excluded due to not meeting eligibility criteria, and one not enrolling due to the trial being closed. Three others choose standard of care treatment over trials and one declined treatment. Two had doctors advise against trials in favor of other options. Three had disease progression preventing further trial consideration and one passed away. Seven of the 23 were still discussing trials at the end of follow up. Six of the initially referred callers chose not to discuss trials with their oncologist. The majority of these (five) reported not feeling a need to discuss trials due to having stable disease on a current treatment. The remaining caller reported feeling a lack of doctor support as reason for choosing not to discuss. Seven of the 36 initial callers were lost to follow-up. Conclusion: Given that 64% of the patients in the pilot program reported discussing trials with their oncologist, a personalized support program may represent an effective means of increasing clinical trial participation among lung cancer patients. This program will be expanded to include more participants and gather more information on barriers to clinical trial participation. Keywords: clinical trials, lung cancer, patient navigation
Abstracts
S2027
P1.11-004 Impact of Liquid Biopsy on the Treatment of LowIncome Lung Cancer Patients A. D’Souza,1 C. Brooks,2 G. In,1 V. Raymond,2 R. Lanman,2 J. Nieva1 1 Oncology, USC Norris Comprehensive Cancer Center, Los Angeles, CA/US, 2 Guardant Health, Redwood City/US Background: A number of patients with lung cancer receive their oncologic care at safety net hospitals that primarily treat low-income patients. These hospitals lack resources for rapid tissue biopsy and do not routinely offer liquid biopsies. Up to 25% of patients with nonsmall cell lung cancer (NSCLC) have insufficient tissue recovered on biopsy for genotyping. Guardant360 is a non-invasive cell-free circulating tumor DNA (cfDNA) test providing comprehensive genomic profiling of genes recommended by the National Comprehensive Cancer Network (NCCN). Method: We enacted a program at Los Angeles County-USC Medical Center aimed at increasing patient access to Guardant360. For testing costs, qualified patients were enrolled in the testing company’s financial assistance program, subject to meeting financial eligibility criteria. Additionally, patients had access to a mobile phlebotomy service. We identified patients with metastatic NSCLC who had undergone Guardant360 testing between August 2016 and February 2017. Medical records were reviewed for results of molecular testing (tissue and cfDNA) and the impact of Guardant360 on clinical decision-making. We also reviewed tissuebased testing for EGFR mutations and ALK rearrangements ordered at Los Angeles County-USC Medical Center on 664 patients with lung cancer from 2005 to 2015. Result: Guardant360 testing was sent on 10 patients with NSCLC, 9 with adenocarcinoma and one with squamous histology. Seven had somatic mutations on cfDNA analysis with 3 of these seven patients having a targetable mutation, as defined by NCCN. Tissue was sent for molecular testing on 5 of the 10 patients with four patients having cfDNA results concordant with tissue results. For the remaining five patients, there was either insufficient tissue for testing (N¼3) or testing was not ordered (N¼2). In this cohort of uninformative tissue results, cfDNA results found one patient with an ALK rearrangement, one patient with a KRAS mutation, and no targetable mutations in three patients. The patient with ALK rearrangement had therapy changed based on Guardant360 results. On review of tissuebased testing for 664 patients, ordered at Los Angeles County-USC Medical Center, there were no ALK and EGFR testing results available for 79% and 75.8% of patients, respectively. Conclusion: Liquid-based biopsies can be useful in identifying patients with targetable mutations. Implementation of programs that give patients access to liquid biopsy in resource-limited environments, in which over 75% had incomplete tissue results, has the potential to impact care. This data highlights the potential benefit of liquid biopsy and illustrates how this program leads to changes in therapy for some patients. Keywords: liquid biopsy, low-income
P1.12-001 Flexible Bronchoscopic Cryotherapy in Patients with Malignant Central Airway Obstruction S.K. Kim, Y.M. Ko, S.Y. Kim, S.H. Song, C.H. Kim Department of Internal Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon/KR Background: Although malignant central airway obstruction has poor prognosis, cryotherapy can be used as a palliative treatment. The objective of this study is to evaluate the role of flexible bronchoscopic cryotherapy in patients with malignant central airway obstruction.
S2028 Method: Clinical data of patients who performed flexible bronchoscopic cryotherapy for recanalization of malignant central airway obstruction from March 2014 to September 2016 were analyzed retrospectively. Result: 29 patients (21 males) were enrolled. Median age was of 65 years (range, 54-82) and median ECOG performance status was 3 (range, 1-3). Causes of malignant central airway obstruction were primary lung cancer of 21 cases (Squamous cell carcinoma, 12 cases; small cell carcinoma, 9 cases) and endobronchial metastasis of 8 cases (soft tissue sarcoma, 2 cases; renal cell cancer, 4 cases; glottis cancer, 1 case; endometrial cancer, 1 case). Obstruction sites were as follows: carina and both main bronchus, 4 cases; left main bronchus, 9 cases; right main bronchus, 8 cases; bronchus intermedius, 8 cases. Degree of obstruction was classified into three categories: complete, 6 cases; partial non-passable with scope, 5 cases; partial passable with scope, 18 cases. Type of obstruction was classified into two types: intrinsic obstruction, 8 cases (all endobronchial metastasis); extrinsic obstruction, 21 cases (all primary lung cancer). Complete recanalization was achieved in 8 cases (27.6%), and all of them were endobronchial metastasis. Partial recanalization was achieved 21 cases (72.4%). Dyspnea was improved in 23 patients (79.3%). There was no immediate complication, such as respiratory failure or massive bleeding. Conclusion: Cryotherapy with flexible bronchoscopy is a feasible and effective treatment for malignant central airway obstruction, especially due to endobronchial metastasis. For more clarification, further prospective study of large scale will be required. Keywords: cryotherapy, lung cancer, Airway obstruction
Journal of Thoracic Oncology
Vol. 12 No. 11S2
of advanced lung cancer. Method: The frequency of FOLR1 expression in primary lung cancer and metastatic lymph nodes was first analyzed by human tissue samples from surgery and endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA). Confocal fluorescence microscopy was then used to confirm the cellular uptake and fluorescence activation in lung cancer cells, and the photocytotoxicity was evaluated using a cell viability assay. In vivo fluorescence activation and quantification of uptake were investigated in mouse lung orthotopic tumor models, followed by the evaluation of in vivo PDT efficacy. Result: FOLR1 was highly expressed in metastatic lymph node samples from patients with advanced lung cancer and was mainly expressed in lung adenocarcinomas in primary lung cancer. Expression of FOLR1 in lung cancer cell lines corresponded with the intracellular uptake of folate-porphysomes in vitro. When irradiated with a 671 nm laser at a dose of 10 J/cm2, folateporphysomes showed marked therapeutic efficacy compared with untargeted porphysomes (28% vs. 83% and 24% vs. 99% cell viability in A549 and SBC5 lung cancer cells, respectively. Systemically-administered folate-porphysomes accumulated in lung tumors with significantly enhanced disease-to-normal tissue contrast. Folate-porphysomes mediated PDT successfully inhibited tumor cell proliferation and activated tumor cell apoptosis. Conclusion: Folate-porphysome based PDT shows promise in selectively ablating lung cancer based on FOLR1 expression in these preclinical models. Keywords: folate receptor 1 (FOLR1), lung cancer, photodynamic therapy (PDT)
P1.12-003 Photothermal Ablation of Lung Cancer by Low Power Near-Infrared Laser and Topical Injection of Indocyanine Green; A Preliminary Animal Study K. Hirohashi,1 T. Anayama,1 H. Wada,2 T. Kato,2 K. Orihashi,1 K. Yasufuku2 1Thoracic Surgery, Kochi Medical School, Kochi University, Nankoku/JP, 2Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON/CA
P1.12-002 Nanoparticle Targeted Folate Receptor 1 Enhanced Photodynamic Therapy for Lung Cancer T. Kato,1 C. Jin,2 H. Ujiie,1 D. Lee,1 F. Kosuke,1 H. Wada,1 H. Hu,1 R. Weersink,3 J. Chen,4 M. Kaji,5 B. Wilson,4 G. Zheng,4 K. Kaga,6 Y. Matsui,6 K. Yasufuku1 1Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON/CA, 2Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto/CA, 3Techna Institute, Princess Margaret Cancer Center, University Health Network, Toronto/CA, 4Department of Medical Biophysics, University of Toronto, Toronto/CA, 5Department of Thoracic Surgery, Sapporo Minami-Sanjo Hospital, Sapporo/JP, 6 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo/JP Background: Despite modest improvements, the prognosis of lung cancer patients has still remained poor and new treatment is urgently needed. Photodynamic therapy (PDT), the use of light-activated compounds (photosensitizers) is a treatment option but its use has been restricted to central airway lesions. Here, we report the use of novel porphyrin-lipid nanoparticles (porphysomes) targeted to folate receptor 1 (FOLR1) to enhance the efficacy and specificity of PDT that may translate into a minimally-invasive intervention for peripheral lung cancer and metastatic lymph nodes
Background: Surgical resection by lobectomy with systematic lymph node dissection is the gold standard of treatment for early stage non-small cell lung cancer. However, minimally invasive tumor ablation can be an alternative treatment for patients not eligible for surgery due to comorbidities. The present study was designed to evaluate the efficacy of photothermal ablation therapy for lung cancer by low power near-infrared laser and topical injection of Indocyanine green (ICG). Method: 6 New Zealand white rabbits were employed for the study. Tumor suspension containing VX2 cancer cells with growth factor reduced Matrigel was inoculated into the lung using an ultrathin bronchoscope. 3 rabbits were treated by laser ablation therapy with topical injection of ICG. Another 3 rabbits were treated by laser ablation alone. All tumors were irradiated with a laser with 500 mW output at 808 nm for 15 min. The tumors were examined histopathologically to assess the ablated areas. Result: The maximum surface temperature of the tumor in rabbits treated by ICG/laser and laser alone were more than 58 C and less than 40 C, respectively. The ablated areas in the rabbits using ICG/ laser were statistically larger than those in the rabbits using laser alone (ICG/laser: 0.49±0.27 cm2 vs laser alone: 0.02±0.002 cm2) (p <0.05). Conclusion: We clarified the efficacy of the photothermal treatment by low power near-infrared laser and topical injection of ICG using a rabbit VX2 orthotopic lung cancer model. This system may be able to be applied for transbronchial laser ablation of peripheral lung cancers. Keywords: Indocyanine green, near-infrared laser, photothermal ablation