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Sung-Min Chun



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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-51 - Next-Generation Sequencing for Effective Detection of Various EGFR Exon 20 Insertions (E20ins) in Non-Small Cell Lung Cancer (NSCLC) (ID 1750)

      10:15 - 18:15  |  Author(s): Sung-Min Chun

      • Abstract

      Background

      Epidermal growth factor receptor (EGFR) E20ins are known as uncommon EGFR mutation and relatively insensitive to current EGFR tyrosine kinase inhibitors (TKIs). However, recent newer TKIs such as poziotinib show good clinical activity against them. Thus, we further explored the rate of EGFR E20ins and their clinical characteristics

      Method

      Between March 2017 and October 2018, 488 NSCLC tumor specimens were examined with OncoPanel AMC version3 which is a Next-generation sequencing (NGS) based assay for the detection of single-nucleotide variants, insertions, deletions, copy number alterations and structural variants across 382 genes. Peptide Nucleic Acid (PNA) clamping method version2 is to detect EGFR mutations using allele specific polymerase chain reaction and 6 variants of E20ins could be detected by it. We analyzed those NGS results and they were compared with PNA clamping method results if examined previously. Clinical characteristics were also reviewed.

      Result

      Among 488 patients, 143 showed EGFR mutations;16 patients showed wide variety of E20ins, while 59, 54 and 14 patients showing exon 19 deletion, L858R, and other rare EGFR mutations, respectively. Thus, the rate of E20ins was 11.2% of all EGFR mutations. For those 16 patients with E20ins, PNA clamping method failed to detect E20ins EGFR mutation in 8 patients (50%). Male/Female ratio was 7/9. Median age was 57 years (25-76 years). The rate of non-smoking was 68.8%. First-line platinum based regimen were given in 10 patients with 2.5 months of median progression free survival (PFS), while first-line EGFR TKIs were given in 5 patients with 2.3 months of median PFS. Poziotinib was provided to 2 patients later and they showed stable disease and partial remission.

      Conclusion

      EGFR E20ins were detected in 11.2% of EGFR-mutant NSCLC by OncoPanel AMC version3, and it was twice the rate by PNA clamping method. Clinically those patients showed lack of response to current EGFR TKIs. Poziotinib is a new EGFR TKI and promising for E20ins EGFR mutation.