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Luís Cirnes
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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: 2
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-24 - Lung Adenocarcinoma: Mutational Profile in Ever Smokers and Non-Smokers Patients (ID 2847)
08:00 - 18:00 | Author(s): Luís Cirnes
- Abstract
Background
Lung cancer occurring in never-smokers had become a distinct entity. This study aims to evaluate the mutational profile in ever smokers and non-smokers patients with pulmonary adenocarcinoma.
Method
Retrospective analysis (Oct-2016 to Aug-2017) of patients diagnosed with pulmonary adenocarcinoma in our pulmonology department.
Next generation sequencing (NGS) was used to identify different mutations and translocations. Pathological variants of genes and variants of uncertain clinical significance were included.
Result
60 patients were enrolled in this study: 18 (30%) non-smokers and 42 (70%) ever smokers.
In 72.2% of non-smokers and 57.1% of ever smokers were identified at least one mutation. Despite this, ever smokers had an overall higher frequency of mutations (72.6% vs 27.4%) because many patients had concomitant mutations.
Although not statistically significant, ever smokers had more mutations that are variants of uncertain clinical significance (40% vs 23.5%; p=0,227)
Table 1. Frequency of mutations
___ Non-smoker Ever smokers
ConclusionMutated gene Pathological variants
(n)
Variants of uncertain clinical significance (n) Pathological variants
(n)
Variants of uncertain clinical significance (n) KRAS 3 0 18 0 EGFR 5 0 4 5 ERBB4 0 0 0 1 MET 0 1 0 3 PTEN 0 0 1 1 HER2 1 2 0 7 PI3KCA 0 1 1 1 BRAF 0 0 1 0 ROS 1 0 1 0 ALK 3 0 1 0 Total 13 4 27 18
Although not statistically significant, smokers and non-smokers appear to have a different mutational profile. Smokers have a higher rate of concomitant mutations, although some of them are variants of uncertain clinical significance. NGS will help to increase knowledge about the mutational profile in these patients.
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EP1.01-80 - Progressive Disease with T790M Mutation vs Non-T790M Mutation in EGFR Positive Patients Treated with Tyrosine Kinase Inhibitors (ID 2781)
08:00 - 18:00 | Author(s): Luís Cirnes
- Abstract
Background
Patients with metastatic non-small cell lung cancer (NSCLC) with a sensitizing EGFR mutation are candidates for treatment with a tyrosine kinase inhibitor (TKI), but acquired resistance is inevitable. The most frequent mechanism of acquired resistance to TKI is the T790M mutation.
Method
Retrospective analysis of patients with EGFR mutation treated with TKI who progressed from November 2016 to July 2018, for whom the T790M mutation testing was done through liquid or tissue biopsy.
Result
Progression disease was observed in 18 patients. The mean age was 67.1 ± 14.4 years. Twelve patients (66.7%) were female. Ten patients (55.5%) presented the T790M mutation as a resistance mechanism to TKI.
T790M positive T790M negative p value Non-smokers
Ever smokers
9 (90%)
1 (10%)
2 (25 %)
6 (75 %)
0.005 EGFR mutation
Exon 18
Exon 19
Exon 21
0 (0%)
8 (80%)
2 (20%)
1(12.5%)
5(62.5%)
2 (25%)
0.604
Initial TKI
Gefitinib
Afatinib
Erlotinib
2 (20%)
0 (0%)
8 (80%)
2 (25%)
3(37.5%)
3(37.5%)
0.146 Response evaluation
Stable disease
Partial response
3 (30%)
7 (70%)
6 (75%)
2 (25%)
0.119 PFS with initial TKI - months (mean ± SD) 11 ± 5.3 10 ± 6.9 0.586 Months treated with initial TKI after disease progression due to clinical benefit (median - IQR) 2 - 5 4 - 3 0.409 Progressive disease
Increase of primary lesion size
Increase of metastasis size
New intrathoracic lesions
New extrathoracic ± intrathoracic lesions
3 (30%)
3 (30%)
2 (20%)
2 (20%)
3(37.5%)
2 (25%)
0 (0%)
3(37.5%)
0.465
Conclusion
The T790M mutation was the most frequent mechanism of TKI resistance. Non-smokers developed the mutation more often than ex-smokers, although this result was not statistically significant. In the other analyzed variables there were no statistically significant differences.
