Molecular profiling of non-small cell lung cancer (NSCLC) in Asia with targeted next-generation sequencing (NGS): Interim analysis of a co-operativ...

Date 23 November 2019
Event ESMO Asia Congress 2019
Session Poster display session
Topics Non-Small Cell Lung Cancer
Personalised/Precision Medicine
Presenter Aaron Tan
Citation Annals of Oncology (2019) 30 (suppl_9): ix122-ix130. 10.1093/annonc/mdz431
Authors A.C. Tan1, H. Loong2, G.F. Ho3, A. Seet1, B. Chiam1, D.Q. Cheah1, G.S. Tan4, K.H. Lim4, J.C. Yang5, T.S.K. Mok2, D. Kim6, D.S.W. Tan1
  • 1Division Of Medical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG
  • 2Department Of Clinical Oncology, The Chinese University of Hong Kong, 00000 - Hong Kong/HK
  • 3Dept Of Clinical Oncology, University Malaya Medical Center, 59100 - Kuala Lumpur/MY
  • 4Department Of Pathology, Singapore General Hospital, 169608 - Singapore/SG
  • 5Department Of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, 100, Taipei/TW
  • 6Department Of Internal Medicine, Seoul National University Hospital, 110-744 - Seoul/KR

Abstract

Background

There is an expanding list of therapeutically relevant biomarkers for NSCLC and effective molecular profiling is paramount. We sought to comprehensively and prospectively evaluate the molecular epidemiology of NSCLC in Asia and ascertain the extent of access to relevant therapies. The study is being conducted by the Asian Thoracic Oncology Research Group (ATORG) – an academic co-operative lung cancer trials group in Asia.

Methods

ATORG-001 is a prospective, multi-centre study of NSCLC patients (pts) throughout Asia. Eligible pts must have good performance status (ECOG ≤2), adequate organ function and ≤3 prior lines of cytotoxic chemotherapy. Archival tissue specimens are sent to a central laboratory in Singapore (Singapore General Hospital) for profiling, consisting of NGS with the Oncomine Focus Assay (52 gene panel including fusions) and PD-L1 immunohistochemistry. Results are returned to investigators in a clinically relevant timeframe. Baseline demographics, pre-existing molecular profile and prior treatment details are collected. Treatment and pt outcomes are followed for 2 years. Recruitment commenced in Jan 2019 in 3 sites (National Cancer Centre Singapore, Chinese University of Hong Kong, University Malaya Medical Centre). We report an interim analysis for the first 27 of a planned 500 pts.

Results

As of 01 Jul 2019, 27 pts have enrolled with median age 67 yrs (range 46-79), 59% male, 81% adenocarcinoma, 52% stage IV, 37% non-smokers, median lines of prior therapy 1 (range 0-6) and 85% with no known oncogenic driver. Pre-existing mutation status was known in 89% for EGFR and 63% for ALK. Median turnaround time from tissue acquisition to profiling results was 22 days (range 15-74). New alterations were most common in KRAS (19%), MYC (15%), CDK4 (7%) and ERBB2 (7%). Potentially actionable new alterations were found in 7 (26%) pts, including KRAS G12C mutation (7%), BRAF G469A mutation (4%), ERBB2 exon 20 insertion (4%), ERBB2 amplification (4%), FGFR2 amplification (4%) and MET exon 14 skipping mutation (4%).

Conclusions

Enrolment is ongoing with additional sites and countries planned to comprehensively evaluate the molecular epidemiology of NSCLC in Asia.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Asian Thoracic Oncology Research Group.

Funding

Asian Thoracic Oncology Research Group, Novartis.

Disclosure

A.C. Tan: Travel / Accommodation / Expenses: ASLAN Pharmaceuticals. All other authors have declared no conflicts of interest.