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Bassam Hazem



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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
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      P2.01-48 - Predictive Factors in NSCLC Patients with Stage IIIB/IV Treated with First Line Platinum-Doublet Chemotherapy (ID 13695)

      16:45 - 18:00  |  Author(s): Bassam Hazem

      • Abstract
      • Slides

      Background

      Predictive factors for response to chemotherapy in non-small cell lung cancer (NSCLC) are deficient. We investigate the associations between mutation status and treatment outcome of first line platinum-doublet chemotherapy in a 1.5 years population-based cohort of stage IIIB/IV patients. Furthermore, we will investigate the usefulness of gene expression signatures in predicting chemotherapy response in patients with advanced NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In the region of Skåne, Sweden, n= 600 (preliminary) patients with NSCLC stage I-IV (TNM 7th edition) had conclusive results from reflex NGS testing with Illumina TruSightTumor 26-gene panel between January 2015 – June 2016. From this cohort, we include all patients with stage IIIB/IV with first line platinum-doublet treatment not interrupted by other cause than progressive disease (PD) and evaluate their extra-cranial response to treatment by using the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 with slight modifications. Patients who received radiotherapy against the primary tumor and/or mediastinum before or concomitant with chemotherapy are excluded.

      4c3880bb027f159e801041b1021e88e8 Result

      So far, 91 patients have been included, 10 (11%) with stage IIIB and 81 (89%) with stage IV. First-line chemotherapy included carboplatin/cisplatin in combination with gemcitabine/pemetrexed/vinorelbine. Bevacizumab were given in addition to chemotherapy in 3 patients. 25 (28%) responded with progressive disease (PD), 27 (30%) with stable disease (SD) and 39 (43%) with partial response (PR). TP53+/KRAS+ tumors were detected in 22 (24%) patients, TP53+/KRAS- in 34 (37%), TP53-/KRAS+ in 21 (23%) and TP53-/KRAS- in 14 (15%). No difference in response to treatment (p=0.6, Fisher’s exact test) or progression-free survival (PFS) (log rank test, p=0.6) according to mutation status was seen, although we observed a weak tendency of worse PFS in TP53+ patients with or without KRAS mutation compared to TP53-/KRAS- patients.

      8eea62084ca7e541d918e823422bd82e Conclusion

      In this population-based Swedish cohort, mutations in KRAS and/or TP53 are not significantly associated with first line chemotherapy response. However, also subtypes of these mutations should probably be considered. Additional analyses of potential predictors of treatment response, in association with other clinicopathological variables, will be presented.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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