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Hideo Saka



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    P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)

    • 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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      P2.16-07 - Impact of de Novo T790M on Outcome for Resected NSCLC from EGFR Mutant Cohort of Japan Molecular Epidemiology (JME) Study (ID 13266)

      16:45 - 18:00  |  Author(s): Hideo Saka

      • Abstract
      • Slides

      Background

      We conducted a prospective multicenter molecular epidemiology study (JME study; Kawaguchi T, J Clin Oncol 2016), collecting 876 surgically resected non-small-cell lung cancer (NSCLC) including 373 EGFR mutated cases and examining 72-gene somatic mutations status using the next generation sequencing. We also previously reported pretreatment T790M mutation was detected in 298 (79.9%) of these EGFR mutated NSCLC patients from JME study cohort utilizing the ultra-sensitive droplet digital PCR (Watanabe M, Clin Cancer Res 2015). Here, we report follow-up data and clinical outcomes in the EGFR mutant cohort of JME study and the impact of pretreatment T790M on recurrence free survival (RFS) and overall survival (OS).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      All the patients were enrolled from July 2012 to December 2013, and clinical and prognostic data were obtained until the end of November 2017. Cox proportional hazards model were applied to assess the impact of pretreatment T790M on RFS and OS, considering age, gender, smoking history, histology, stage, history of adjuvant chemotherapy, EGFR mutation status, TP53 and number of coexisting mutations.

      4c3880bb027f159e801041b1021e88e8 Result

      Median follow up time was 48.6 months, and 373 patients were analyzed: 182 were ≥70 years; 97 were men; 93 had smoking history; 361 were adenocarcinoma; 290/43/40 were stage I/II/III-IV; 120 received the adjuvant chemotherapy, 19 had uncommon EGFR mutation, 92/11 had one/two somatic mutations and 69 had TP53 mutation. In RFS, univariate analysis showed event risk tended to be higher in pretreatment T790M positive group than negative group (HR=1.76, 95%CI: 0.98-3.15, p=0.06), but multivariate analysis also couldn’t show significance (HR=1.62, 95%CI: 0.89-2.94, p=0.12). Multivariate analysis showed age (≥70 vs. <70, HR=2.07, 95%CI: 1.34-3.19), gender (male vs. female, HR=1.88, 95%CI: 1.03-3.44), pathological stage (II vs. I, HR=4.10, 95%CI: 2.32-7.21; ≥III vs. I, HR=10.49, 95%CI: 6.07-18.15) and the number of coexisting mutations (2 vs. 0, HR=2.77, 95%CI: 1.07-7.17) were significantly associated with RFS. In OS, although pathological stage (II vs. I, HR=3.61, 95%CI: 1.45-8.96; ≥III vs. I, HR=6.64, 95%CI: 2.92-15.12) was significant prognostic factor, pretreatment T790M positive was not associated with event (HR=1.32, 95%CI: 0.53-3.27, p=0.55).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our study showed pretreatment EGFR-T790M was not a prognostic factor for RFS and OS in surgically resected NSCLC. Cases in younger age, female and less number of coexisting mutations were associated with longer RFS, while earlier stage was significantly associated with both improved RFS and OS in resected NSCLC.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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