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Heather Wakelee
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GS01 - Opening & Keynote Lectures (ID 7)
- Event: NACLC 2019
- Type: Invited Speaker Session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 10/10/2019, 18:00 - 19:30, Rouge (Lobby Level)
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GS01.02 - Welcome from the IASLC President Elect (ID 142)
18:00 - 19:30 | Presenting Author(s): Heather Wakelee
- Abstract
Abstract not provided
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GS08 - Closing Plenary (ID 14)
- Event: NACLC 2019
- Type: Invited Speaker Session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 10/12/2019, 11:30 - 12:30, Imperial Ballroom (B2 Level)
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GS08.04 - Closing Remarks (ID 193)
11:30 - 12:30 | Author(s): Heather Wakelee
- Abstract
Abstract not provided
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OA01 - Precision Medicine and Personalized Therapy for Lung Cancer (ID 1)
- Event: NACLC 2019
- Type: Oral Abstract Session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 10/11/2019, 14:00 - 15:40, Imperial Ballroom (B2 Level)
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OA01.11 - Discussant: NGS Path Forward with IASLC (ID 901)
14:00 - 15:40 | Author(s): Heather Wakelee, Heather Wakelee
- Abstract
Abstract not provided
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OA03 - IO Concerns and Targeted Therapies (ID 3)
- Event: NACLC 2019
- Type: Oral Abstract Session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 10/12/2019, 09:45 - 11:15, Rouge (Lobby Level)
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OA03.07 - Evaluating Racial Differences in KRAS-Mutant Non-Small Cell Lung Cancer (ID 68)
09:45 - 11:15 | Author(s): Heather Wakelee
- Abstract
Background:
KRAS mutations occur in ~25% of patients with non-small cell lung cancer (NSCLC) and have been observed at a higher frequency in Caucasians. However, racial differences in outcomes remain unclear. In this study, we assessed for differences in clinical, molecular, and pathologic features as well as treatment and survival outcomes among racial subgroups in patients with KRAS-mutant NSCLC.
Method:
We identified patients with KRAS-mutant NSCLC who underwent next-generation sequencing of >130 genes with the Solid Tumor Actionable Mutation Panel (STAMP) assay at the Stanford Cancer Institute between January 2015 and December 2017. We used descriptive statistics to evaluate and compare baseline characteristics among racial subgroups. We used multivariable Cox proportional hazards models to evaluate the associations between race and overall survival (OS) from date of biopsy-proven diagnosis, OS from initiation of immunotherapy, and time on treatment with immunotherapy.
Results:
Among 186 patients identified, the median age was 72 years (range 40-90) and 57% were female. In total, 146 (78.5%) patients were Caucasian, 24 (12.9%) were Asian, 12 (6.5%) were Hispanic, and 4 (2.2%) were African American. Significantly fewer Asians had a positive smoking history compared to the other subgroups (45.8% vs 91-100%; P<0.001). There were no significant differences in disease stage (P=0.463) and histology (P=0.410) across subgroups. A greater proportion of Hispanics had KRAS G12D mutations compared to the other subgroups (41.7% vs 12-33%; P=0.007), a borderline greater proportion of Caucasians had KRAS G12C mutations (39.7% vs 8-25%; P=0.058), and no differences were observed with KRAS G12V mutations (P=0.653). A greater proportion of African Americans had KEAP1 co-mutations compared to the other subgroups (75% vs 0-8%; P<0.001), and no differences were observed in other co-mutations including TP53 and STK11. PD-L1 positivity did not differ across subgroups (P=0.869). On multivariable analysis, Hispanics had a significantly improved OS compared to Caucasians (HR 0.30, 95% CI 0.10-0.86, P=0.026). No significant differences were observed in OS from initiation of immunotherapy, but Hispanics had a significantly shorter duration of treatment compared to Caucasians (HR 2.79, 95% CI 1.03-7.25, P=0.044).
Conclusion:
There are notable racial differences in the molecular profiles of patients with KRAS-mutant NSCLC. Hispanics with KRAS-mutant NSCLC demonstrate improved survival outcomes compared to Caucasians, in line with patterns observed in lung cancer epidemiologic studies. Hispanics had a shorter duration of treatment with immunotherapy, but this did not impact treatment outcomes.
