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Beung Chul Ahn

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    P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.01-01 - ROS1-Positive Non-Small Cell Lung Cancer: Real-World Data in Korea (ID 11799)

      16:45 - 18:00  |  Presenting Author(s): Beung Chul Ahn

      • Abstract
      • Slides


      ROS1 rearranged non-small cell lung cancer (NSCLC) is classified as a distinct molecular subset with a therapeutically druggable target. ROS1 rearrangement is most often identified in never-smoker with adenocarcinoma and EGFR and ALK wild type patients. Treatment with tyrosine kinase inhibitors (TKIs) which target the ROS1 kinase domain is considered standard of care for the ROS1-positve NSCLC, by showing a robust and durable response. However, information regarding the clinical characteristics and the outcomes of TKI treatment in the real world remains limited.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We have identified 103 consecutive cases of ROS1-positive NSCLC from January 2001 to February 2018 by break apart fluorescence in situ hybridization (FISH) (n=84), next-generation sequencing (n=23) or both (n=3). Information on fusion breakpoints was available for 8 patients. Clinical data including patient characteristics, incidence of brain metastasis, and response to chemotherapy or TKI were retrospectively analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      The median age was 56 years, 58.9% of patients were female, and 75.7% were never smokers. Adenocarcinoma was predominant (98.1%), and 2 cases with pleomorphic carcinoma were identified. Sixty percent of patients had an extra-thorax metastatic lesion, and 22% had intracranial lesion at the initial presentation or at the time of recurrence. Median time to brain metastases was 12.0 months (range 2.1 to 84.1). Majority of the patients received palliative chemotherapy (93.2%), and 7.8% of patients received definite concurrent chemoradiotherapy. Most common fusion partner was CD74 followed by SDC4, EZR, TPM3, TFG, ZCCHC8, SLMAP, and MYO5C, all of which had preserved tyrosine kinase domain of ROS1. There were no clinical correlations between different fusion partners and TKI treatment outcomes. The median overall survival for the study population was 52.1 months (95% confidential interval [CI] 23.6 – not reached). For 90 patients treated with pemetrexed-based chemotherapy, the overall response rate (ORR) and progression-free survival (PFS) was 53.3% and 8.0 months (95% CI 6.4 – 11.7), respectively. The ORR and PFS was 70.7% and 12.7 months (95% CI 8.1 – 21.8) for 50 patients treated with TKI. Brain metastasis was more commonly observed during the TKI treatment (15.5%) than pemetrexed-based chemotherapy (6.7%).

      8eea62084ca7e541d918e823422bd82e Conclusion

      ROS1-positive NSCLC has distinct clinical characteristics with high and durable response to both TKI and pemetrexed-based chemotherapy. Given its novel characteristics and distinct clinical responses to conventional chemotherapies and TKIs, the treatment strategy for ROS1-positive NSCLC remains to be further developed.


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