Author of

• 30292

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  EP1.01 - Advanced NSCLC (ID 150)

  • Event: WCLC 2019
  • Type: E-Poster Viewing in the Exhibit Hall
  • Track: Advanced NSCLC
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall

  • 30366

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    EP1.01-67 - Molecular Profiling of K-Ras and Its Subtypes in NSCLC Patients with Liver Metastasis (Now Available) (ID 2802)

    08:00 - 18:00  |  Author(s): Daniel Chandra
    • Abstract
    • Slides

    Background
    

    Non-small cell lung cancer (NSCLC) tend to have a poor prognosis in the presence of liver metastasis. Molecular profiling of NSCLC has played a major role in identifying a number of oncogenic targets that have led to novel targeted therapies. KRAS is a frequently mutated gene in NSCLC, occurring in approximately 30% of lung adenocarcinomas and most commonly manifesting as the transversion mutations G12C, G12V, G12A. there are presently no targeted therapies approved for KRAS-mutant NSCLC. Immunotherapy has emerged as a standard of care for first-line treatment of advanced NSCLC, specifically through targeting the programmed cell death protein-1 (PD-1/PD-L1). Given the aggressive nature of KRAS-mutant NSCLC with liver metastases and the lack of approved therapies targeting the KRAS pathway, checkpoint blockade immunotherapy may represent an impactful primary therapeutic option for these patients.

    Method
    

    The CARIS database from 2016 - 2018 was queried and patients with NSCLC were identified. PD-L1 antibody 22c3 ≥1% was considered positive. PD-L1 expression as well as k-ras and TP53 mutation status were analyzed and correlation between different variables were identified using ANOVA

    Result
    

    We identified 361 patients with NSCLC having Liver metastasis. Median age was 67. Gender distribution was equal (51.4% males, 49.7% females). Of the 361 patients, we identified 74 patients with mutated K-ras. Thirty nine out of the 74 patients had PD-L1 expression (52.7%). Twenty one patients had the G12C sub-type (28%) with 14 patients (66%) having positive PD-L1 expression.Of the 287 patients with wild type K-ras, 115 patients had PD-L1 positive expression (40%) with no statistical significance (P=0.134) in comparison to the k-ras mutant population.We also studied 2237 K-ras mutant patients without liver metastases where 882 patients had the G12C subtype (39.4%). On the other hand, only 21 patients were positive for G12C k-ras subtype out of the 74 k-ras mutant patients with liver metastases.Among patients with liver metastases, adenocarcinoma was the most common histological subtype (223 patients), Carcinoma NOS was the second common histological subtype (61 patients).Patients with no liver metastasis had median age of 68. Gender distribution was equivocal.

    Conclusion
    

    Patients with k-ras mutant G12C subtype were associated with more frequent PD-L1 expression and less occurrence of liver metastases.

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