Author of

• 25933

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  P1.13 - Targeted Therapy (Not CME Accredited Session) (ID 945)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26613

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    P1.13-22 - Clinical Features and Outcomes of NSCLC Patients with Uncommon EGFR Mutations Treated with EGFR-TKIs (ID 13371)

    16:45 - 18:00  |  Author(s): Karen Kopciuk
    • Abstract
    • Slides

    Background
    

    Non-small cell lung cancers with common epidermal-growth factor receptor (EGFR) mutations (exon 19 deletion and exon 21-point mutation L858R) are known to greatly benefit from EGFR-tyrosine kinase inhibitors (TKIs). However, much less is known about the treatment responses of EGFR mutations such as L861Q, G719X and double EGFRmut⁺ carriers. In this study, we report clinicopathological and treatment outcomes of patients harboring such EGFR mutations and treated with EGFR-TKIs.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Between 2009 – 2015, 233 EGFRmut⁺ NSCLC patients treated at two Alberta-based cancer centres, Tom Baker Cancer Centre (Calgary) and Cross Cancer Institute (Edmonton) were screened retrospectively via the provincial cancer registry and the Glans-Look Lung Cancer Database. Clinicopathological and treatment outcomes were analyzed. Overall survival was assessed using the Kaplan-Meier method and compared using the log-rank test. Outcomes of single versus double EGFRmut⁺ carrier sub-groups were compared using Fisher’s Exact test.

    4c3880bb027f159e801041b1021e88e8 Result
    

    42/233 (18%) patients harbored uncommon EGFR mutations: 14/42 (33%) carried single rare EGFRmut⁺ and 11/42 (26%) carried double EGFRmut⁺, meanwhile 41% couldn’t be specified. Most frequently detected uncommon single EGFR mutations were G719X (12%) and L861Q (17%). Table 1 summarizes clinical characteristics and TKI efficacy amongst uncommon EGFR mutations. Compared to single EGFR mutants, double EGFR mutation carriers were older (median age 71yrs vs 69 yrs), have a smoking-history (73% vs 50%), experienced longer median OS and PFS (15 and 12 months p < 0.001, vs. 9 and 3 months p = 0.0014 respectively), and were also more likely to continue with a TKI beyond initial-TKI-PD (82% vs 28%).
    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Retrospective real-world data illustrating the experience and outcomes of uncommon EGFR mutation carriers was explored in this study. Additionally, our results, although limited by cohort-size, highlights that tumor responses from TKI treatments vary amongst uncommon EGFRmut⁺ carriers, with most favorable survival responses observed in double EGFR mutants.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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• 25957

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  P3.03 - Biology (Not CME Accredited Session) (ID 969)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27499

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    P3.03-21 - CXCR4 Overexpression is Associated with Poor Survival Outcome After Recurrence in Early Stage Non-Small Cell Lung Cancer Patients (ID 13659)

    12:00 - 13:30  |  Author(s): Karen Kopciuk
    • Abstract

    Background
    

    Overexpression of CXCR4 is associated with poor outcomes for patients with advanced non-small cell lung cancer (NSCLC). Studies suggest a gender specific difference in outcomes of stage IV NSCLC patients, with shorter survival in females with high expression of CXCR4. The current study evaluates the association between CXCR4 expression and gender, time to recurrence, and survival in early stage NSCLC patients.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Patient characteristics, clinical variables and outcome data were obtained from the Glans-Look Lung Cancer database for stage I-III NSCLC patients diagnosed between 2003-2006 at the Tom Baker Cancer Centre. Tissue microarrays were created from surgical or biopsy specimens, and CXCR4 expression was evaluated using quantitative fluorescent immunohistochemistry. CXCR4 expression and outcome data were analyzed using a Cox proportional hazards and multi-state model.

    4c3880bb027f159e801041b1021e88e8 Result
    

    230 patients with stage I-III NSCLC were identified, and 181 patients had corresponding tissue for CXCR4 analysis. Early stage NSCLC patients with CXCR4 overexpression had worse overall survival compared to those with low CXCR4 expression (p<0.05). No gender specific difference was observed. Time to recurrence did not correlate with CXCR4 expression, and there was no association with the site of recurrence (local versus distant). However, high CXCR4 expression was associated with increased risk of death after recurrence (p<0.05).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Early stage lung cancer patients with high CXCR4 expression have worse survival outcomes, particularly after recurrence of disease. The role of CXCR4 as a prognostic marker in NSCLC patients who have recurred should be further elucidated.

    6f8b794f3246b0c1e1780bb4d4d5dc53