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Anurag Mehta

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    P1.01 - Advanced NSCLC (ID 757)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.01-030 - Predictive Biomarkers in Non-SmallCell Carcinoma and Their Clinical Association (ID 8512)

      09:30 - 16:00  |  Presenting Author(s): Anurag Mehta

      • Abstract

      Recognition of molecular targets, such as EGFR, ALK, ROS and MET involved in cell signaling have led to the development of new targeted therapies.Widespread use of predictive markers has generated new data on prevalence and clinicopathological correlates. However, there is a lack of comprehensive data from Indian subcontinent. This study identifies clinical, histomorphological and molecular corelates of biomarker positive NSCCl.

      Archival data of NSCC patients diagnosed with stage IV diseasea was retrieved. Those who tested positive for one of the four biomarkers EGFR, ALK, MET, ROS from January 2010 to December 2016 were included. EGFR testing was done using Qiagen EGFR TherascreenRGQ PCR KIT. ALK-1 protein was tested by FDA approved immunohistochemistry.Ros-1 gene rearrangement was assessed using Dual Color Break Apart DNA probe (Zytolight). C- MET gene amplification assay was done using Zytolight labeled LSI MET DNA probe(green)and cen-7 probe(orange). Epidemiological patient profile and tumor histomorphology on small biopsies was correlated with molecular signature and assessed with treatment response and overall survival.

      Of the total 1938 lung cancer patients included in our study, 347 patients were observed to exhibit positivity for either one among four molecular markers. Among 347 patients, 77.8% had EGFR mutation. Of these del 19 was commonest and observed in 55% cases, L858R in 27.6% cases,Exon 20 Insertion in 5% and G719X in 3% cases. 7% of these EGFR mutants showed dual mutation.ALK-1 protein overexpression was seen in 19.3% . ROS rearrangement was present in 0.8% . MET amplification was observed in 2%. Predominant histological type was adenocarcinoma (87.6%) with predominant solid pattern. The median overall survival for EGFR, ALK, ROS, MET were 13.44,11.5, 17.2 and 15.1 months respectively. Sex, age, histology, mutation type and performance status affected overall survival.

      DEL 19 L858R EXON 20I G719X DUAL OTHERS(L861Q) (T790M)
      CASES 151 76 14 10 19 01 67 03 07
      % 55 27.6 5 3 7 0.3 19.3 0.8 2
      OS 13.4 12.5 14.5 13 12.6 11 11.5 17.2 15.1

      Biomarker testing has improved outcome and provides new insight to cancer clinicopathological profile.