1255P - Clinical features and outcome in never-smoker (NS) non-small cell lung cancer (NSCLC) patients (pts): A single-institution observational analysis

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Aetiology, Epidemiology, Screening and Prevention
Non-Small Cell Lung Cancer
Basic Scientific Principles
Presenter Chiara Bennati
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors C. Bennati1, R. Chiari1, G. Metro1, D. Iacono1, M. Varella-Garcia2, D. Aisner2, V. Minotti3, M. Meacci1, L. Paglialunga1, V. Ludovini4, V. De Angelis1, L. Marcomigni1, F.R. Tofanetti5, S. Baglivo1, G. Bellezza6, L. Crinò7
  • 1Medical Oncology, Ospedale S. Maria della Misericordia, 06156 - Perugia/IT
  • 2School Of Medicine, University of Colorado, CO/US
  • 3Medical Oncology, Santa Maria della Misericordia Hospital, 06156 - Perugia/IT
  • 4Medical Oncology, S. Maria della Misericordia Hospital, 06132 - Perugia/IT
  • 5Medical Oncology Division, S. Maria della Misericordia Hospital,, 06132 - Perugia/IT
  • 6University Of Perugia, Institute of Pathological Anatomy and Histology, University of Perugia, Perugia, Italy, 06132 - Perugia/IT
  • 7Oncologia Medica, Ospedale S. Maria della Misericordia, 06156 - S. Andrea delle Fratte/IT



NSCLC in NS often harbors proto-oncogene aberrations, showing enrichment for targetable alterations compared to unselected populations. Objectives of this study were to define the proportions of the driver gene alterations and to examine survival in genotype-specific subsets of NS NSCLC.


We identified 243 NS NSCLC pts treated at our Institution from October 2003 to January 2014. Pts with tissue available for biological analysis were as follows: 207 pts (85.1%) assessable for EGFR/KRAS mutation, 77 (31.6%) for ALK rearrangement, 37 (15.2%) for ROS1 rearrangement, 33 (13.5%) and 32 (13.1%) for RET fusion and HER2 mutation. The cohort comprised 58% women, median age 62, 86% advanced adenocarcinomas (10% brain metastases at diagnosis).


Out of 207 tumors, frequency of EGFR and KRAS mutation was 42.5% (88 pts) and 7.7% (16), respectively. Among pts screened for ALK, ROS1, RET, HER2, the proportion of individual testing, were 25.9% (20), 13.5% (5), 9% (3), 0%. 228 pts were evaluable for treatment and outcomes.158 pts (69%) received at least one line of an EGFR tyrosine kinase inhibitor (TKI), of which 42 (27%) as first line. 16 pts (7%) received an ALK/ROS1 inhibitor, and 8 pts (4%) had both treatments, 50 pts (21%) received exclusively chemotherapy. Median progression-free survival (PFS) after treatment with first line EGFR TKI was 13.2 months (mo) vs 5.3 mo for chemotherapy (p < 0.001). Median PFS after a II line TKI (114 pts) was 14.1 mo. Median overall survival (OS) for EGFR mutans, ALK/ROS1 positive and chemotherapy-only treated pts was: 31.8 mo, not reached, and 14.1 mo, respectively (p < 0.001). Median OS for KRAS mutated vs KRASwt pts was 32.2 mo vs 17.4 mo (p 0.363).


The study confirmed the clinical and outcome features which make lung cancer in NS a distinct disease. Of particular note is the marked increase in OS with EGFR TKI therapy when evaluating this subset in contrast to previous studies not specifically focusing on NS.


All authors have declared no conflicts of interest.