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A.D. Bhatt



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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      53P - Lung cancer: Beyond EGFR and ALK dichotomy (ID 359)

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

      • Abstract
      • Slides

      Background:
      Lung cancer, one of the most frequent cancers worldwide has long relied on molecular testing of major biomarkers such as EGFR/ALK. Achieving superior clinical outcomes needs a comprehensive emphasis beyond contemporary EGFR and ALK. Several technologies arose in par with molecular testing for EGFR/ALK, most of them failing to comprehend beyond due to a universal skepticism among clinicians though recommended in NCCN guidelines.

      Methods:
      A total 137 lung cancer cases from NGS tested data (PositiveSelect) comprising 91 males and 46 females were investigated. EGFR, ALK positivity were used for data dichotomization to understand therapeutic utility of rare alterations beyond EGFR/ALK.

      Results:
      Upon dichotomization, 28% were identified with EGFR + ALK variants favoring direct EGFR/ALK targeted therapeutics. The remaining 72% harbored no EGFR/ALK variants descending into the category of chemotherapy in current clinical practice. Similarly, 23% harbored EGFR variants carrying the beneficial effects of EGFR TKIs and remaining 77% displayed no EGFR variants sloping towards chemotherapy. The study conquered the incompetence of targeted drug utilization on conventional diagnosis of EGFR/ALK in (EGFR) and (EGFR + ALK) negative cohorts. Based on our analysis of EGFR negative cohort, we identified clinically actionable variants in KRAS (7%), BRAF (2%), ERBB2 (1%), MET (2%) and RET (3%) expressing potential for targeted therapy excepting EGFR TKIs. Correspondingly, KRAS (6%), ERBB2 (1%), MET (1%) and RET (3%) variants were identified in EGFR + ALK negative cohort enabling the utility of targeted therapeutics apart from EGFR/ALK. Only 35% of the two negative limbs were categorized into chemotherapy which would have been entire cohort otherwise.

      Conclusions:
      The study accentuates the potential of comprehensive genomics in ascertaining the hallmarks of lung cancer beyond EGFR/ALK dichotomy also liaising between theory and utilization of broad spectrum genomic testing among medical professionals to circumvent chemotherapy. Thus, chemotherapy dependence in EGFR/ALK negative cohort could be effectively curtailed by clinicians evidencing better clinical outcomes.

      Clinical trial identification:
      NA

      Legal entity responsible for the study:
      Positive Bioscience

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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