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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
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
EP1.01-86 - Comprehensive Next-Generation Sequencing-Guided Targeted Therapy Correlates with Survival in Non-Small-Cell Lung Cancer (Now Available) (ID 2455)
08:00 - 18:00 | Author(s): Binbin Lu
Although increasingly common in clinical practice, whether genetic testing confers a survival benefit remains to be firmly established.Method
We performed retrospective analysis of 82 lung adenocarcinoma patients who were diagnosed at the Second Affiliated Hospital of Nanjing Medical University from 2013 to 2018. We evaluated progression-free survival (PFS) with respect to genetic testing status.Result
63 (77%) patients received targeted next-generation sequencing. Of these, 43 (69%) patients received tailored targeted TKI therapies. No significant difference in mPFS was observed between patients with and without genetic testing (Fig.1). However, an increase in PFS started to manifest at later times in patients who received genetic testing. In patients treated with osimertinib, PFS was longer in those who received genetic testing and had EGFR T790M mutation status confirmed (Fig.2 and Table 1). A cis-C797S mutation was identified in a patient who progressed on osimertinib treatment. Patient 6 with EGFR L858R responded poorly to osimertinib. We found that genetic testing was conducted using a 139-gene panel, and more comprehensive testing may be necessary to uncover potential resistance mechanism(s) to osimertinib in this patient.
Table 1. NSCLC patients treated with osimertinib Patient ID Age/Gender Sample Type Previous Targeted Therapy Mutations PFS (months after osimertinib 1 65 / F Blood Gefitinib
20 2 59 / F Blood/Tissue Gefitinib
30 3 54 / M Blood Erlotinib
MAP2K1 p. C121S
0.3 4 48 / M Blood Osimertinib
4 5 87 / M Tissue Osimertinib EGFR p.745_750del 10 6 48 / M Blood Osimertinib EGFR p.L858R 4 7 77 / M Blood/Tissue No EGFR p.L861Q 18 8 60 / F Blood Gefitinib
15 9 77 / M Tissue Gefitinib KRAS 7 10 50 / M Blood/Tissue Osimertinib No 18 11 79 / M Blood/Tissue Osimertinib EGFR p.L858R 5
Routine genetic tests should implemented in treating patients with advanced NSCLC, particularly in those who developed resistance to first-generation TKIs.
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