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Leena Solanki



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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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      P1.01-44 - Outcome of Uncommon EGFR Mutation Positive Newly Diagnosed Advanced NSCLC Patients: A Single-Centre Retrospective Analysis (ID 13955)

      16:45 - 18:00  |  Author(s): Leena Solanki

      • Abstract
      • Slides

      Background

      The significance of uncommon EGFR mutations in newly diagnosed advanced NSCLC patients is incompletely known. We aimed to analyze the demographic profile, outcome and treatment attributes of these patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively surveyed 5738 advanced NSCLC patients who underwent EGFR testing in our centre from 2013 to 2017 by in-house primer probes on real time PCR platform. Descriptive data was accumulated from electronic medical records. Survival plot was calculated from Kaplan Meir and compared between groups using Log Rank test.

      4c3880bb027f159e801041b1021e88e8 Result

      Out of 1260 EGFR mutation positive patients, 83 (6.58%) had uncommon mutations in isolation or in various combinations. Uncommon mutations were more frequent in men than in women (59% vs.41%), in never smokers than in smokers (65.1 % vs. 20.5%) and in adenocarcinomas than non -adenocarcinomas (96.4% vs. 3.6%). Overall Exon18G719X, Exon20insertion, Exon20T790M, Exon20S768I , Exon21(L858R/L861Q ) were present in 9.6%, 19.3%, 12%, 3.6% and 3 .6% patients respectively . Dual mutation positivity was found in 50.6% patients. One patient (out of 83) had triple mutations: Exon18G719X, Exon20S768I and Exon21L858R. On classifying patients as per TKI sensitivity, it was found that TKI sensitive single and dual mutations were found in 15.7 % and 4.8% respectively .TKI insensitive single mutations were found in 31.3% and a combination of TKI sensitive and insensitive mutations was found in 48.2 % patients. The median duration of follow up was 13 months. Five patients were lost to follow up. Overall 50.6% patients received oral TKI and 34.9% received chemotherapy as first line therapy. Response to first line therapy could be assessed in 54 patients, out of whom 28 had partial response, 14 had stable disease and 12 had progression. Median progression free survival (PFS) on first line therapy was 8.3 months (CI 5.3-12.9). Median overall survival of patients who received TKI during the course of their disease was 20.2months (CI 11.4 -28.9). Median overall survival of the entire cohort was 15.8 months (CI 10.1-21.5). Among all uncommon mutations, patients with dual mutations did better, with a median overall survival time of 22.6 months (CI 8.2-37.0, P=0.005) . It was observed that TKI Sensitive/ TKI Insensitive Dual mutations had a superior overall survival of 28.2 months (CI 15.2-41.2,P=0.042) as compared to TKI Sensitive (single or dual) and TKI Insensitive single uncommon EGFR mutations.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Uncommon EGFR mutations constitute a distinct heterogeneous group, hence it is imperative to understand each subgroup more to define optimal treatment.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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