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Binbin Lu



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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
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      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

      • Abstract
      • Slides

      Background

      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.

      2019 wclc figure 1.png2019 wclc figure 2.png

      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

      EGFR p.745_750del

      EGFR p.T790M

      20
      2 59 / F Blood/Tissue Gefitinib

      EGFR p.746_751del

      EGFR p.T790M

      30
      3 54 / M Blood Erlotinib

      EGFR p.L747_T752del

      MAP2K1 p. C121S

      NF1 p.L732X

      0.3
      4 48 / M Blood Osimertinib

      EGFR p.L858R

      EGFR p.T790M

      EGFR p.C797S

      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

      EGFR p.L858R

      EGFR p.T790M

      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

      Conclusion

      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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