Author of

• 35370

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  ES21 - The "How To" of Modern Tobacco Control (ID 152)

  • Event: WCLC 2020
  • Type: Educational Session
  • Track: Risk Reduction and Tobacco Control
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/31/2021, 09:15 - 10:15, Scientific Program Auditorium

  • 35371

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    ES21.01 - Chair (ID 3963)

    09:15 - 10:15  |  Presenting Author(s): Sita Andarini
    • Abstract

    Abstract not provided

• 36598

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  P89 - Targeted Therapy - Clinically Focused - Translational (ID 266)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Targeted Therapy - Clinically Focused
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 36624

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    P89.15 - Multiple Driver Oncogenes from Plasma of NSCLC Patients (ID 3736)

    00:00 - 00:00  |  Presenting Author(s): Sita Andarini
    • Abstract
    • Slides

    Introduction
    

    Lung cancer is one of the leading mortality of all cancer in Indonesia. Pathological diagnosis is important step for further treatment plan. Molecular marker from cytological samples or tissue such as EGFR mutation, ALK, ROS-1, are further step to choose personalized treatment. Currently, NGS-based liquid biopsy taken from plasma of lung cancer patients are available in Indonesia.

    Methods
    

    Oncomine Lung Panel cfTNA Assay for 12 genes are available in Indonesia. The panel includes 12 different genes covering more than 169 hotspots, 49 fusions, and MET exon 14 skipping. The twelve genes covered are as follows: ALK, KRAS, PIK3CA, BRAF, MAP2K1 RET, EGFR, MET, ROS1, ERBB2, NRAS, TP53. Here we presented cases with multiple driver oncogene and the sequential treatments

    Results
    

    Here we presented case with multiple driver oncogene and the sequential treatments. A 52 yo gentlement was diagnosed as lung adenocarcinoma T4N3M1 stage IV on March 2016. While waiting for EGFR mutation, he was having 2 cycle of chemotherapy of cisplatin-pemetrexed-bevacizumab, and EGFR mutation result was mutation exon 21 L858R. Soon the treatment was changed to erlotinib 150mg from March 2016 to December 2016; and due to additional single new node, bevacizumab 5mg/bw was added threeweekly, due to pleural effusion, enlarged tumor size and continue to osimertinib, and continued on osimertinib plus bevacizumab. On March 2019 he showed PD, and his plasma NGS on March 2019 showed EGFR del 19, EGFR T790M, BRAF V600E, TP53 R273H, TP53 Y220C. He was underwent chemotherapy with carboplatin, pemetrexed, bevacizumab for 6 cycles, and continued with maintenance pemetrexed bevacizumab. On December 2019, his plasma NGS showed EGFR On May 2020, he was admitted to do severe breathlesness, and PD due to severe lesion in the liver and respiratory failure, and he passed away due to respiratory failure. A second case was a 52 year old female with diagnosis of lung adenocarcinoma T4N3M1 EGFR mutation exon 19, and was treated with erlotinib. She was PD, and the result was EGFR mutation del 19, exon 21, and TP53. She was underwent whole brain irradiation, and passed away due to tumor progression.

    Conclusion
    

    Althouh already mentioned driver oncogenes in NSCLC in other countries, here we reported first multiple driver oncogene detected on NGS plasma on heavily pretreated patients in Indonesia and outcomes. Further study were needed to elaborate panel of driver oncogenes in Indonesian population and its response to treatments.

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