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A. Jung



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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      108P - NSCLC patients harbouring a rare or complex EGFR mutation are more often smokers and might not benefit from first line TKI therapy (ID 479)

      12:30 - 13:00  |  Author(s): A. Jung

      • Abstract

      Background:
      TKI therapy is definitely standard in first line treatment of patients with advanced NSCLC harbouring a classic EGFR mutation (Exon 19 deletion or Exon 21 L858R). However, a certain percentage of patients have rare or complex EGFR mutation with unknown relevance regarding prognosis and response to TKIs. For those patients, therapy decisions remain challenging.

      Methods:
      343 patients with NSCLC, who underwent EGFR mutation testing, were analysed in this study with regard to epidemiological characteristics as age, sex and smoking status as well to EGFR mutation status classified into wild type, classic, rare, synonymous, T790M and complex mutations. Further rare and complex mutations of 12 patients who received TKI therapy were analysed regarding to response to TKI treatment.

      Results:
      282 (82%) of all patients were EGRF wild type, whereas 61 (18%) harboured an EGFR mutation. Most of them appeared to be classic mutations 32 (9%), followed by rare (16 (5%)) and complex (7 (2%)) mutations. Synonymous and T790M resistance mutations were found in 3 and 4 patients respectively. EGFR mutations were significantly more frequent in women than in men. It was noticeable that patients with rare or complex mutations were significantly more often smokers compared to classic EGFR mutations. Further the rare and complex mutations showed to be less responsive to TKI therapy.

      Conclusions:
      Smoking seems to enhance the probability of rare or complex EGFR mutations. Besides, those mutations might not benefit from first line TKI therapy, so that the presence of EGFR mutation alone should not necessarily lead to induction of a TKI therapy and in case of TKI treatment to close surveillance. In fact, type of mutation, reports of response and patient characteristic as performance status should lead the decision.

      Clinical trial identification:


      Legal entity responsible for the study:
      Department of Internal Medicine V, University Munich

      Funding:
      Department of Internal Medicine V, University of Munich

      Disclosure:
      All authors have declared no conflicts of interest.