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yizhi Li

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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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      P1.01-59 - A Better Real World Practice for ROS1 Positive NSCLC Patients, Driven by the Targeted Next Generation Sequencing(NGS) and the Targeted TKI (ID 11766)

      16:45 - 18:00  |  Author(s): yizhi Li

      • Abstract


      Methodologically, Targeted NGS had been shown comparable to classical testing methods in testing sensitivity and specificity in several driver genetic aberrations. However, Data of standard TKI treatment outcome in NGS identified ROS1-positive NSCLC was rare, especially in TKI confirmatory clinical trials, thus it is practical and necessary to evaluate it in the real world.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We carried out a real word retrospective study in our center. From September 2015 to December 2017, NSCLC in-patients with targeted NGS testing (Burning Rock Dx; 8 genes or 56 genes panel) results were included in our study. Data of NGS multiple genes testing, crizotinib efficacy and potential clinical and genetic influential factors, and safety were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      1104 NSCLC patients with targeted NGS testing (Burning Rock Dx; 8 genes or 56 genes panel) results were included in our study. All testing was based on tumor biopsy and adenocarcinoma is the domain histology. The occurrence rate of ROS1 rearrangement was 1.5 %( N=17). Seven phenotypes of ROS1 rearrangement were detected and the most common one was CD74-ROS1, which accounted for 45% (9 of 20). Furthermore, three patients were found carrying two different ROS1 rearrangements. 41% (7 of 17) patients were discovered with other concomitant mutations: including TP53 &PIK3CA mutation(n=1), TP53&CDKN2A mutation(n=1), TP53 & BRCA2 mutation(n=1), PIK3CA &ALK missense mutation (p.R311H)(n=1), MET amplification(n=1) ,TP53 mutation(n=1), ERBB2 mutation(n=1), Among all NSCLC patients with ROS1 rearrangement, 13 patients were diagnosed at stage IV and 12 patients received crizotinib treatment. The average follow-up period since crizotinib initiation was 12.7 months (range from 1.5 to 28 months). The ORR and DCR of crizotinib were 75% and 83% (9 PR, 1 SD and 2 NA) respectively. The median progression-free survival (mPFS) of crizotinib treatment was 14 months. Of influential factors analysis, it was shown that NSCLC patients with exclusive ROS1 rearrangement had a longer PFS than those carrying concomitant mutations (mPFS 15.5months vs 8.5months; p=0.0213) and there was no significance impact on PFS considering brain metastasis, crizotinib treatment lines or rearrangement subtypes. No grade 3 and 4 adverse events were observed in this retrospective study.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Crizotinib is highly effective and tolerant in NGS identified ROS1 rearrangement advanced NSCLC in real-word clinical practice and the data is consistent with that in the previous clinical trials applying IHC/FISH/RT-PCR as ROS1 companion diagnosis. NSCLC patients with exclusive ROS1 rearrangement had better PFS under Crizotinib treatment compared to those with concomitant mutations.