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Wallace Akerley

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • 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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      P3.01-13 - Prognosis of Non-driver, Never Smoker Metastatic Non-Small Lung Cancer (NSCLC) (ID 12381)

      12:00 - 13:30  |  Author(s): Wallace Akerley

      • Abstract
      • Slides


      The overwhelming majority of NSCLC does not have an actionable driver mutation, termed wild type (WT). Never smoking (NS) lung cancer has a high frequency of actionable driver mutations relative to smoking (S) related lung cancer. Those with EGFR or ALK mutations who receive appropriate targeted therapy, regardless of smoking status, demonstrate twice the survival of WT NSCLC in the metastatic setting. It is unclear if WT NS behaves more like WT S or EGFR/ALK.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Electronic medical record data from lung cancer patients treated at Huntsman Cancer Institute was processed by Flatiron Health using technology-enabled abstraction and supplemented with third-party death information. Patients with metastatic NSCLC were categorized according to smoking status (never [NS] or history of smoking[S]) and molecular profile (EGFR, ALK or WT). Kaplan-Meier estimates of survival from advanced/metastatic diagnosis were plotted by category, and survival times compared between groups in the context of Cox proportional hazards models.

      4c3880bb027f159e801041b1021e88e8 Result

      From 2016, 202 patients were identified with smoking data and EGFR/ALK testing in the data set. The respective median ages and median survival in the NS WT, ALK/EGFR, and S WT groups were 68 (N=31), 63 (N=71), and 68 (N=100) years and 1.8, 1.8, and 0.7 years, respectively. Estimated survival curves are shown below. NS WT was the reference population with hazard ratio=1. Hazard ratios for the remaining categories were ALK/EGFR 1.09 (p=0.823) and S WT 2.64 (p=0.005).


      8eea62084ca7e541d918e823422bd82e Conclusion

      Survival times for NS WT are significantly greater than S WT NSCLC and behave more like EGFR/ALK. Clinical history may be more important than molecular biomarkers, but further study is needed.


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