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Mohanakrishnan Jayamani
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P76 - Targeted Therapy - Clinically Focused - EGFR (ID 253)
- 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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P76.04 - Prospective Study on Molecular Biomarkers in Advanced Lung Adenocarcinoma and Predilection for EGFR Mutation with Metastatic Sites (ID 852)
00:00 - 00:00 | Presenting Author(s): Mohanakrishnan Jayamani
- Abstract
Introduction
Lung cancer is the most common cancer worldwide and it is the third leading cause of cancer mortality in India. More than 50% of the patients have advanced disease at the time of diagnosis. Targeted therapy have improved their survival but there is less awareness among pulmonologists regarding the new biomarkers other than EGFR (Epidermal growth factor receptor) and about genome sequencing techniques. This study was done to find the various molecular biomarkers in advanced adenocarcinoma and to correlate with clinico- epidemiological factors and also to find any predilection for EGFR mutation with the site of metastases.
Methods
Study was conducted between1st January 2019 to 30th November 2019 after institutional review board approval. Participants were from Department of Chest Medicine and Department of Medical Oncology of Ruby Hall Clinic, a tertiary cancer care hospital located in Pune, India. Total 57 patients of histopathologically proven lung adenocarcinoma and advanced disease confirmed by PETCT scan were recruited. Patients with multiple malignancies and who were not willing for the study were excluded.
Molecular biomarkers were identified from the tissue samples using next generation sequencing (NGS) in 41 patients while for remaining 16 only EGFR strip assay was done due to patients’ financial constraints. The entire data is statistically analyzed using Statistical Package for Social Sciences (SPSS ver 22.0, IBM Corporation, USA).
Results
Of 57 cases studied, 28 (49.1%) were male and 29 (50.9%) were female. The mean age of the study group is 57.90 ± 12.07 years and the minimum – maximum age range was 27 – 86 years. Study group included 3 patients from overseas while the rest (n=54) were Indians. Study population include, 5 (8.8%) tobacco chewers, 12 (21.0%) smokers, 40 (70.2%) non-smokers and nearly 71 % of study group either were farmers or home-makers. Of 41 cases studied on NGS, 23 (56.1%) negative for all biomarkers, 9 (21.9%) EGFR positive, 4 (9.7%) MET positive, 2 (4.9%) HER2 positive, 1 (2.4%) ALK positive, 1 (2.4%) ALK + BRAF positive and 1 (2.4%) EGFR + PDL1 >50% positive and EGFR strip assay was positive in seven. A total of 17 patients out of 57 were positive for EGFR mutation with the prevalence of 29.8% and among them 8 (47.1%) had EXON 19 mutation, 1(5.8%) had EXON 20 mutation and another 8 (47.1%) had EXON 21 type of mutation. In our study EGFR mutation seen in 32.1% of males and 27.1% in females while in non-smoker category females are more affected (53.3%). Pleural site of metastasis was significantly correlated with EGFR mutation (p value 0.032) and the most common site of metastasis in EGFR mutation positive patients was Brain (p value 0.054).
Conclusion
Next generation sequencing (NGS) is the need of the hour to detect various molecular biomarkers. According to our study, predilection for EGFR mutation is seen in patients having pleural or brain metastasis. Awareness among pulmonologists about NGS and various biomarkers other than EGFR mutation is absolutely necessary as specific targeted therapy available against those has proven impact on survival in advanced lung cancer.
