Author of

• 25938

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  P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

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

  • 26803

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    P2.01-09 - Targetable Genomic Alterations in KRAS Mutant Lung Adenocarcinoma by Targeted Next Generation Sequencing (ID 13705)

    16:45 - 18:00  |  Author(s): Imane Chaib
    • Abstract
    • Slides

    Background
    

    KRAS mutant (m) non-small cell lung cancer (NSCLC) represents 25% of cases. Despite the common mutation, biological and clinical behaviour of this disease is diverse. The aim of our study was to analyze co-occurring genomic alterations in advanced KRASm lung by next-generation sequencing (NGS) and compare them to a KRAS wild-type (WT) population.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Advanced lung adenocarcinoma patients treated with a platinum doublet with KRAS mutation by Sanger were submitted to targeted NGS with the Oncomine Solid Tumor kit (DNA) and compared to a KRAS WT population of clinically similar patients. Association with outcome of the genomic alterations was evaluated.

    4c3880bb027f159e801041b1021e88e8 Result
    

    32 KRASm patients and 18 WT patients were analyzed. The most frequent KRAS mutation was p.Gly12Cys (45%), followed by p.Gly12Val (24%). TP53 mutation was observed in 55% of KRASm tumors and 60% of WT cases (Table 1). Mutations in STK11 were found in 10% of cases in the KRAS mutant cohort while none in the WT. 3 out of the 4 cases of STK11 mutations coexisted with TP53 mutations. FGFR3, SMAD4 and DDR2 mutations were more frequently found in cases with KRAS mutations, although at low frequencies. Neither KRAS nor TP53 mutations had an impact in OS. We then selected the KRAS mutant cohort and evaluated the impact of co-mutations. TP53 or STK11 did not significantly affect OS of KRAS mutant patients.

    Table 1. Co-ocurring alterations in KRAS mutant and WT tumors

    Mutations/CNG	KRAS mutant % (N: 38)	KRAS WT % (N: 15)
    TP53 mut	55%*	60%*
    STK11 mut	10%**	0%
    FGFR3 mut	13%	6%
    SMAD4 mut	8%	0%
    DDR2 mut	5%	0%
    MYC mut	5%	6%
    KRAS CNG	8%	6%

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    KRASm lung adenocarcinoma is genomically diverse. NGS provides biologically relevant information and druggable targets in this subset of 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

  • 26951

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    P2.03-15 - Integrin-Linked Kinase (ILK), Protein Tyrosine Phosphatase SHP2 and B lymphoma Mo-MLV Insertion Region 1 Homolog  (Bmi-1) in EGFR-Mutant NSCLC (ID 12557)

    16:45 - 18:00  |  Author(s): Imane Chaib
    • Abstract
    • Slides

    Background
    

    The clinical efficacy of EGFR tyrosine kinase inhibitors (TKIs) in EGFR-mutant non-small cell lung cancer (NSCLC) is jeopardized by the activation of multiple signaling pathways. ILK regulates the expression of Bmi-1, a well-known epithelial mesenchymal transition-inducing transcription factor. SHP2 function is required for MAPK pathway activation, and also plays a role in receptor tyrosine kinase signaling pathways.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Clinical data were assessed in accordance with the protocol approved by the institutional review board and de-identified for patient confidentiality. Pretreatment tumor specimens from advanced EGFR-mutant NSCLC patients (pts) were collected from eight sites in Spain, France, Italy and Colombia. mRNA gene expression analysis was performed by TaqMan (qRT-PCR). We examined the mRNA levels of ILK, SHP2 and Bmi-1.

    4c3880bb027f159e801041b1021e88e8 Result
    

    With a median follow-up of 26.7 months, median progression-free survival (PFS) was 9.3 (95% CI, 7.6-14.2) and 15.7 months (95%CI, 12.3-30.1) for pts with high and low ILK mRNA, respectively (P=0.0002), (HR for disease progression, 2.4; 95% CI, 1.3-4.5; P=0.002). Median PFS was 11.4 (95% CI, 8.2-14) and 24.1 months (95% CI, 8.2-30.9) for pts with high and low SHP2 mRNA, respectively (P=0.009), (HR, 2.4; 95% CI, 1.2-4.7; P=0.01). Median PFS was 8.2 (95% CI, 4.8-13.1) and 24.1 months (95% CI, 14.2-36.5) for pts with high and low SHP2 mRNA, respectively (P=0.001), (HR, 2.9; 95% CI, 1.4-5.9; P=0.002). Median overall survival (OS) was 17.9 (95% CI, 13.2-33) and 34.4 months (95% CI, 18.5-44.2) for pts with high and low ILK mRNA, respectively (P=0.200), (HR, 1.5; 95% CI, 0.79-3; P=0.200). Median OS was 18.5 (95% CI, 14-33) and 36.7 months (95% CI, 16.7-47.1) for pts with high and low SHP2 mRNA, respectively (P=0.018), (HR, 2.5; 95% CI, 1.1-5.8; P=0.020). Median OS was 17.6 (95% CI, 8.6-39.1) and 36.7 months (95% CI, 19.1-64.1) for pts with high and low Bmi-1 mRNA, respectively (P=0.004), (HR, 2.2; 95% CI, 1.0-5.1; P=0.040).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The disturbance of RTKs, including ILK-SHP2-Bmi-1 axis, occurs frequently in EGFR mutant NSCLC patients, significantly limiting the PFS and OS. The levels of ILK, SHP2 and Bmi-1 could be predictive for upfront combinatory therapy of EGFR TKI plus a MAPK pathway inhibitor (SHP2 or MEK inhibitors).

    6f8b794f3246b0c1e1780bb4d4d5dc53

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