Author of

• 25935

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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

  • 26686

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    P1.15-19 - Treatment of Choice for First-Line Therapy of EGFR-Mutated Stage IIIB Lung Adenocarcinoma Based on the Real World Data (ID 13665)

    16:45 - 18:00  |  Author(s): Ziming Li
    • Abstract
    • Slides

    Background
    

    There is a lack of consensus on the choice of first-line therapy for stage IIIB EGFR-mutated lung adenocarcinoma.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    A prospectively maintained database at the Shanghai Chest Hospital was used to identify patients who received therapy for stage IIIB EGFR-mutated lung adenocarcinoma between 2015 and 2017. Clinicopathological data were extracted from the database and analyzed. Patients were stratified into four groups based on the therapy they received; chemotherapy alone, chemoradiation (concurrent or sequential), first-generation EGFR-TKI, or surgical resection with or without chemoradiation. Log-rank test and Kaplan-Meier method were used to determine significant differences in the progression free survival (PFS) between treatment groups

    4c3880bb027f159e801041b1021e88e8 Result
    

    Of the 114956 patients treated at the institution during the study period 85 (0.07%) were eligible for the study. 12 patients (14.1%) received chemotherapy, while 19 (22.4%), 30 (35.3%) and 24 (28.2%) received chemoradiation, EGFR-TKI and surgery respectively. The common mutations included Del19 (N=35, 41.18%), L858R (N=42, 49.41%), G719X (N=4, 4.71%) and S768I (N=2, 2.35%).

    The median PFS was shorter in patients who only received chemotherapy (8.5 months) as compared to those managed with chemoradiation (14.6 months), EGFR-TKI (16.2 months) or resection (18.6 months) (p=0.04,figure 1b). No statistically significant difference was observed in PFS between EGFR-TKI and chemoradiation (p=0.86), or EGFT-TKI and resection (p=0.90). A subgroup analysis of patients with N3 disease resulted in similar findings (figure1c).

    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    In conclusion, when used as a first-line therapy chemoradiation, EGFR-TKI and resection with or without chemoradiation can achieve similar PFS, which is superior to that of patients receiving chemotherapy alone. Further studies are required to elucidate the efficacy of EGFR-TKI as a first-line or as maintenance therapy for these patients.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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• 25940

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  P2.03 - Biology (Not CME Accredited Session) (ID 952)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 26948

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    P2.03-12 - EGFR and ERBB2 Germline Mutations in Chinese Lung Cancer Patients and Their Roles in Genetic Susceptibility to Cancer (ID 12560)

    16:45 - 18:00  |  Author(s): Ziming Li
    • Abstract
    • Slides

    Background
    

    Inherited genetic determinants of lung cancer risk remains relatively elusive. Rare germline mutations in EGFR and ERBB2 have previously been reported in lung cancer patients, which may be associated with the genetic susceptibility to lung cancer.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We retrospectively analyzed the next-generation sequencing (NGS) results targeting 416 cancer-relevant genes, including the whole exons of EGFR and ERBB2, in a cohort of 9091 Chinese lung cancer patients.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Of the 9091 Chinese lung cancer patients, nine germline mutations from 12 patients were identified within or adjacent to the kinase domain of EGFR: K757R (two patients), D1014N (two patients), I646S, G724S, V786M, T790M, L792F, R831H, and L844V, and one germline mutation was identified adjacent to the kinase domain of ERBB2: V1128I. The incidence of EGFR T790M germline mutation is much lower compared with the reported frequency in the Caucasian patients. Somatic mutations detected in the 12 patients carrying rare EGFR/ERBB2 germline mutations were most commonly EGFR exon19 deletion, L858R, and G719S mutations, and rare EGFR: S768I mutation and a novel D770delinsDNPH indel mutation. The superior response to afatinib of the patient carrying only EGFR L844V germline mutation suggests that this germline mutation might be sensitive to TKI treatment.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Here we indentified eight novel EGFR germline mutations and the ERBB2: V1128I germline mutation were linked to the genetic susceptibility of lung cancer in Chinese population.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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