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Selina K Wong
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P09 - Health Services Research/Health Economics - Real World Outcomes (ID 121)
- Event: WCLC 2020
- Type: Posters
- Track: Health Services Research/Health Economics
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P09.18 - COVID-19 Outcomes in Patients With Thoracic Malignancies According to Gender and Ethnicity (TERAVOLT) (ID 3702)
00:00 - 00:00 | Author(s): Selina K Wong
- Abstract
Introduction
Previously reported data on patients with thoracic malignancies who develop COVID-19 have suggested a higher mortality rate compared to the general population and to other cancer types, particularly in patients over 65 years of age or suffering from active or progressive disease. Preliminary data from other studies have suggested that gender and ethnicity may also impact patient outcomes.
Methods
TERAVOLT is a multi-center, international observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria include the presence of any thoracic cancer and a COVID-19 diagnosis confirmed in the laboratory with RT-PCR/serology, highly suspicious radiological and clinical findings, or suspected with symptoms and known contact with a positive person. The overarching goals of this consortium are to provide data for guidance to oncology professionals on managing patients with thoracic malignancies while understanding the risk factors for morbidity and mortality from this novel virus. Clinical outcomes including hospitalization, ICU admission, oxygen requirement and mortality were collected. The association between demographic/clinical characteristics and outcomes were measured with odds ratio with 95% confidence intervals using a logistic regression model.
Results
As of August 20, 2020, a total of 1,053 patients with COVID-19 and thoracic cancers from 19 countries and 130 centers have been identified, including 42% females and 84% White, 9.3% African American, 25% Hispanic. The median age of male patients was 69 compared to 66 years of age for females. While ECOG PS was similar between treatment groups, 77% of males were admitted to hospital with a mortality rate of 37% compared to 66% of females with a mortality rate of 28%. The median age of African American patients was 66 years of age compared to 68 and 69 years of age for white and Hispanic patients, respectively; 26% of African American and 25% White patients had an ECOG PS ≥2 compared to 19% of Hispanics. A similar percentage of patients were admitted to the hospital and ICU, while the mortality rate for Hispanics was 36% compared to 34% for whites and 26% for African Americans.
Conclusion
Similar to the general population, the mortality rate of males with thoracic cancer is higher than females. Regarding ethnicity, there is a difference in the median age of African American patients compared to Whites and Hispanics. Although the severity of COVID-19 disease, as defined by hospital admission, is similar between ethnic groups, the mortality rate in Hispanics is higher. We will present a multivariate analysis of these data according to gender and ethnicity, including the impact of cancer stage, prior cancer therapy, and COVID-19 therapy on outcomes.
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P85 - Targeted Therapy - Clinically Focused - MET (ID 262)
- Event: WCLC 2020
- Type: Posters
- Track: Targeted Therapy - Clinically Focused
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P85.05 - MET Exon 14 Skipping Mutation Positive Non-Small Cell Lung Cancer: A Population-Based Cohort (ID 848)
00:00 - 00:00 | Presenting Author(s): Selina K Wong
- Abstract
Introduction
MET exon 14 skipping is a potentially targetable molecular alteration. The goals of this study were to identify patients with MET exon 14 skipping to understand prevalence, biology and response to treatment, and to identify molecular signatures that may predict for response or resistance to targeted MET therapy.
Methods
British Columbia Cancer provides care for a population of 5.1 million. A laboratory-developed focused DNA-based next generation sequencing (NGS) panel was performed on advanced non-squamous non-small cell lung cancer (NSCLC) and selected never-smoking squamous patients. Patients with advanced NSCLC found to have MET exon 14 skipping alterations between January 2016-September 2019 were identified. Retrospective chart review was completed to collect baseline characteristics, response to systemic treatments, and outcomes. Median overall survival (OS) was calculated using the Kaplan Meier method.
Results
Forty-three patients out of 1,934 tested were identified with MET exon 14 skipping (2.2%). Forty-one patients had metastatic disease: median age 77 years, female 46%, non-squamous/squamous/mixed adenosquamous 85/12/2%, current or former/never smoking status 61/39%, median number of pack years 30.
Thirty-three patients received systemic therapy; 24 patients treated with crizotinib in the first/second line setting 87/13%. Response rate was PR/SD/PD/NE 21/33/25/21% for a disease control rate (DCR) of 54.2% in the evaluable patients. Median time to treatment discontinuation (TTD) for crizotinib was 2.2 months with 5 patients still on therapy and 3 stopping due to toxicity. Eleven patients received platinum-based chemotherapy with PR/SD/PD/NE 9/64/18/9% and DCR of 73% in the evaluable patients. Median time to platinum discontinuation of 2.8 months. Fourteen patients received immunotherapy (IO) with PR/SD/PD/NE 7/43/21/29% and DCR of 50% in the evaluable patients. Median time to IO treatment discontinuation 2.4 months. Median OS for metastatic patients treated with any systemic therapy was 14.6 months.
Molecular details of 41 patients: PDL1<1%/PDL1 1-49%/PDL1>50%/unknown status was 7/17/63/12%. MET variant frequency <50/>50% 76/24%. MET alteration type: 2% CBL binding domain mutation, 34% poly- pyrimidine tract deletion, 63% splice donor mutation or deletion. Co-mutations: 20% TP53 alterations, 22% other, 59% none.
In this small cohort there were no clear correlations between molecular aberrations and response, TTD or OS.
Conclusion
The prevalence of MET exon 14 skipping in a North American population was 2.2%. Unlike other targeted mutations, patients were older and more commonly current or former smokers. Patients with MET exon 14 skipping alteration demonstrate disease control with crizotinib, platinum-based chemotherapy and immunotherapy. Co-mutations with p53 were commonly noted. Correlation between co-mutations and efficacy of therapy were not identified in this cohort.
