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Aaron Galaznik
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P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)
- 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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P1.15-05 - The Frequency and Spectrum of EGFR Exon 20 Insertions in NSCLC: A Global Literature Review (ID 11975)
16:45 - 18:00 | Author(s): Aaron Galaznik
- Abstract
Background
There are limited epidemiological data on non-small cell lung cancer (NSCLC) patients with non-classical (uncommon) epidermal growth factor receptor (EGFR) mutations. In light of ongoing development of TAK-788, we describe the global frequency and spectrum of EGFR exon 20 insertions in NSCLC based on a comprehensive literature review as well as highlight possible regional variations.
a9ded1e5ce5d75814730bb4caaf49419 Method
A literature search was conducted to identify publications reporting the frequency of EGFR exon 20 insertions in unselected NSCLC patients. PubMed and ASCO, ESMO, and IASLC meeting abstracts were searched up to April 2018 using the following keywords: non-small cell lung cancer, epidermal growth factor receptor, exon 20, insertions and uncommon mutations. Only publications in English were included. The pooled frequency of EGFR exon 20 insertions for each country were determined, and insertion variants (where available) were described at the global level.
4c3880bb027f159e801041b1021e88e8 Result
A total of 26 studies from 25 countries were included, reporting on 569 patients with EGFR exon 20 insertions among 41,321 NSCLC patients. The highest mutation frequency was seen in China (2.9%) and the lowest in Indonesia (0.1%). When pooled by country, exon 20 insertions were found in 0.1−2.1% of all NSCLC.
Over 50 insertion variants were reported, covering amino acids 761−774. The most commonly detected mutations included D770_N771insSVD, V769_D770InsASV, H773_V774InsH, H773_V774insNPH, and A763_Y763insFQEA.
8eea62084ca7e541d918e823422bd82e Conclusion
The frequency of EGFR exon 20 insertions was 0.1−2.1% of NSCLC patients, with a high variability in both length and position of insertions within exon 20. Currently, available data are sparse and come primarily from studies based on single-center experiences, with data gaps across several large geographic regions and populations. Results also indicate a need to further explore underlying geographic variations in epidemiology. Larger, multi-center global studies will further help to refine the frequency of exon 20 insertions and other uncommon mutations in NSCLC.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.15-03 - Capturing the Patient Experience for the Treatment of EGFR Exon 20 Mutations in Non-Small Cell Lung Cancer (ID 12301)
12:00 - 13:30 | Presenting Author(s): Aaron Galaznik
- Abstract
Background
Non-small cell lung cancer (NSCLC) accounts for 80−85% of new lung cancer cases, which presents as metastatic disease 40−50% of the time. The prevalence of NSCLC patients with a mutation in the epidermal growth factor receptor (EGFR) varies by ethnicity, ranging from 15−50%, and EGFR exon 20 insertion mutations specifically account for 7−12% of all EGFR mutations.
Health-related quality of life (HRQOL) was widely used, as generic measures may lack the sensitivity required to demonstrate clinical change related to new therapies. Assessments of disease-specific patient-reported outcomes (PROs) play an important role in clinical trials to evaluate the benefits of new treatments on HRQOL and in making treatment decisions for patients. This study aimed to better understand the overall symptom experience and HRQOL impact from the perspective of NSCLC EGFR exon 20 patients to evaluate the effectiveness of new treatments.
a9ded1e5ce5d75814730bb4caaf49419 Method
A targeted literature review was conducted in Embase and Medline (2007−2017) to identify PROs used in previous NSCLC studies for evidence of content coverage. Interviews with expert clinicians were conducted to explore the clinical perspective on treatment and observed patient experience. Following approval from an independent review board, semi-structured qualitative interviews were conducted with NSCLC patients identified through the International Cancer Advocacy Network.
4c3880bb027f159e801041b1021e88e8 Result
Five oncologists were interviewed, reporting a wide range of NSCLC symptoms, notably shortness of breath, chest pain, bone/other pain, and substantial emotional impacts. Ten patient interviews were conducted (median age 55 [42−83] years; 60% female, 90% EGFR exon 20 insertions, median disease duration 1.8 [<1−6] years, 60% self-reported brain metastases). The most frequently reported disease related symptoms included fatigue (90%), pain (70%), shortness of breath (70%), cough (60%), weakness (30%), phlegm/congestion (30%), and hemoptysis (20%). Symptoms indicative of brain metastases included issues with vision and headaches (both 30%), speaking (20%), and balance (10%). All patients mentioned experiencing a psychological or emotional impact, with 60% describing worry/anxiety around treatment, the future, or finances. Patients also described experiencing negative impacts on daily activities, including household chores and self-care (60%), work (50%), social activities (50%), and family life (40%).
8eea62084ca7e541d918e823422bd82e Conclusion
Incorporation of the patient voice provided valuable in-depth insight on the NSCLC patient experience. Symptom and HRQOL impact concepts identified will inform the iterative development of a conceptual disease model. Results show the significant social, emotional, and physical impact on patients’ lives, which fill an important gap and help to inform treatment decision making.
6f8b794f3246b0c1e1780bb4d4d5dc53
