Author of

• 16831

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  P1.06 - Poster Session with Presenters Present (ID 458)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16832

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    P1.06-001 - Incidence of Molecular Testing and Outcomes of Treatment with Tyrosine Kinase Inhibitors in Advanced Non-Small Cell Lung Cancer in a Dutch Population (ID 6151)

    14:30 - 15:45  |  Author(s): R. Sluga
    • Abstract

    Background:
    Introduction: Tyrosine kinase inhibitors (TKIs) for treatment of advanced EGFR mutated adenocarcinoma were shown in many studies to be superior to chemotherapy in terms of progression-free survival. Since most data is derived from studies on Asian populations, there is a lack of data from other ethnicities. In the Netherlands the guidelines recommend that EGFR-mutation analysis should be performed in all patients with stage IIIb and IV adenocarcinoma and a non-small cell lung cancer-not otherwise specified(NSCLC- NOS). The aim of this study was to investigate the compliance to the guidelines in terms of determination of EGFR mutations, prevalence of EGFR mutations and the outcomes of treatment with the TKIs in a cohort of European patients with advanced NSCLC harboring an EGFR mutation.
    
    Methods:
    Methods: Data was obtained by retrospective analysis of the medical records of patients with a stage IIIb and IV non-small cell lung cancer between 2009 and 2014 in the two top-clinical hospitals in the Netherlands.
    
    Results:
    Results: The total number of patients included in the study was 1022. Molecular diagnostic tests were performed in 57.8% of patients with advanced adenocarcinoma or NSCLC-NOS. The prevalence of performing molecular diagnostic tests improved significantly between 2009 and 2014 (25,2% to 74,4% respectively). Positive EGFR mutation was found in 43 patients (in 9,1% of all molecular diagnostic tests performed). 72,1% of patients harboring an EGFR mutation were treated with TKIs.A significant overall survival benefit with a mean survival of 763 days was seen in EGFR positive patients treated with TKIs (with or without prior/subsequent chemotherapy) versus 435 days in patients treated with conventional chemotherapy (hazard ratio (HR): 0.719. 95% confidence interval (CI): 0.587-0.881). A large fraction of the patients with EGFR-mutated tumors were either initially or after progression treated with chemotherapy. EGFR positive patients who were prior to TKI treatment treated with chemotherapy had significantly longer survival in comparison to patients treated only with chemotherapy (1201 days vs 435 days respectively (HR: 3.289, 95% CI: 1.551-6.997). 10 patients were not treated with TKIs, either because of poor performance status (40%), patient’s refusal (30%), rapid disease progression (20%) or T790M mutation (10%).
    
    Conclusion:
    Conclusion: This study showed that incidence of molecular testing improved significantly over the course of the last years, leading to more effective targeted therapy. Overall survival was significantly prolonged in patients harboring an EGFR mutation treated with chemotherapy prior to TKIs, compared to patients without EGFR mutation treated only with conventional chemotherapy