Clinical research data shows that early mutation testing for pts with NSCLC stage IV could lead to an effective choice of therapy for pts with proven mutations. Targeted therapies achieve a higher ORR, OS, PFS and a better quality of life than chemotherapy in mt+ pts. With the advent of 2nd and 3rd generation TKÍs effective in 1st generation TKI resistant tumors, we wanted to study the impact of these drugs on the outcome of pts in a real life setting.
1381 pts from three cancer centers diagnosed with non-squamous cell NSCLC stage IV (UICC 7) were examined. Methods for the mutation testing was performed according to the German Oncopedia guidelines using either Sanger Sequencing or COBAS® or Next Generation Sequencing (hybrid capture NGS, New Oncology Cologne).
879/1381 (64%) consecutive pts with non-squamous cell NSCLC from three cancer centers were studied for the presence of tumor mutations, especially for EGFR and ALK mt+. The EGFR mt+ rate was 16.6% (141/847), and the ALK-translocation rate 3.8% (24/635). Median OS in EGFR mt+ pts was 28 (n = 79) vs. 28 (n = 38) vs. 16 (n = 14) months respectively (center 1 vs. center 2 vs. center 3). Median OS in ALK mt+ pts was 24 months (n = 17) in center 1 and 11 months (n = 5) in center 2 (p
Small differences in OS were observed, depending on the treatment centers, but the use of multiple EGFR and ALK-I impacted highly significantly on the outcome of pts with EGFR and ALK mt+ in a real life setting.
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Faculty 6 University of Oldenburg
M. Falk: Member of Advisory board: Boehringer Ingelheim, Pfizer Professional fee: Roche, Astra Zeneca, Boehringer Ingelheim. M. Tiemann: Member of Advisory board: Novartis, Boehringer, Roche, Astra Zeneca Professional fee: Novartis, Boehringer, Roche, Astra Zeneca Corporate-sponsored Research: Novartis. L. Heukamp: Member of advisory board: BMS, Boehringer, Roche Diaganostics, Novartis F. Griesinger: Advisory board/Scientific Support/Professional fee: Ariad, Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myer-Squibb, Celgene, Clovis, Lilly, Merck-Sharp-Dome, Novartis, Pfizer, Roche. All other authors have declared no conflicts of interest.