Abstract 66P
Background
As new targeted therapies with CNS penetration and activity for non-small cell lung cancer (NSCLC) with ROS1 gene fusions (ROS1+) emerge, there is a need to characterize the disease course of patients (pts) receiving current treatment, especially in relation to CNS metastases (met).
Methods
We evaluated an anonymized cohort of ROS1+ NSCLC pts from the Flatiron Health electronic health record (EHR)-derived database of US cancer centers (2011–2018). Descriptive statistics were used for clinical and treatment pattern characterization. Kaplan-Meier curves estimated median overall survival (OS), real-world progression-free survival (rwPFS, using physician documentation in the EHR) and rwPFS in the CNS, from 1st-line treatment (1L) after diagnosis of advanced/metastatic NSCLC (aNSCLC Dx). Due to low numbers of pts in some groups, 95% CI are not reported.
Results
We identified 129 ROS1+ aNSCLC pts who received 1L treatment including crizotinib (n = 52, 40.3%), chemotherapy (n = 34, 26.4%), combination systemic therapy (n = 25, 19.4%), clinical study drug (n = 4, 3.1%), or no treatment (n = 14, 10.9%). For 1L crizotinib (the only approved therapy for ROS1+ NSCLC) after aNSCLC Dx median rwPFS: 8.6 m (95% CI: 6.2–12.1); OS: 19.9 m (95% CI: 15.1–NR). For pts receiving other 1L drugs median rwPFS: 5.9 m (95% CI: 4.1–7.2); OS: 18.1 m (95% CI: 12.9–34.6). There were 24 pts (18%) with CNS met at diagnosis and 20 pts (19%) at follow-up. Most pts with CNS met at or after diagnosis received surgery/radiotherapy (37/44, 84.1%). For CNS met pts who received 1L crizotinib after local treatment (6/11), median rwPFS: 8.0 m; OS: 27 m. From 1L crizotinib, pts with CNS met at follow-up only (10/21 pts with CNS mets who received 1L crizotinib), median rwPFS: 7.2 m; rwPFS-CNS: 9.1 m; OS: 15.1 m. For pts with no CNS mets anytime median rwPFS: 10.0 m; OS: 21.5 m from 1L crizotinib (34/55 pts).
Conclusions
In the US, ROS1+ NSCLC pts receive various 1L treatments after aNSCLC Dx. CNS was a site of metastasis in 44/129 ROS1+ NSCLC pts. Surgery/radiotherapy for CNS mets prior to systemic therapy may be associated with favorable outcomes, however conclusions on the natural history of cancers with rare mutations rely on very small patient numbers.
Clinical trial identification
Editorial acknowledgement
Editorial support was provided by Laura Vergoz and Charlotte Kennerley, PhD of Gardiner-Caldwell Communications and was funded by F. Hoffmann-La Roche.
Legal entity responsible for the study
F. Hoffman-La Roche.
Funding
F. Hoffman-La Roche.
Disclosure
M.G. Krebs: Advisory / Consultancy, Officer / Board of Directors: Roche, Achilles Therapeutics, Octimet, Janssen; Research grant / Funding (institution): AstraZeneca, Bayer, BerGenBio, Blueprint, Carrick, Immutep, Incyte, Janssen, Merck, Octimet, Roche; Research grant / Funding (institution): Roche, BerGenBio; Travel / Accommodation / Expenses: AstraZeneca, BerGenBio. L. Perez: Research grant / Funding (institution), Shareholder / Stockholder / Stock options: Roche. A. Surinach: Full / Part-time employment: Genesis Research . R.C. Doebele: Shareholder / Stockholder / Stock options: Rain Therapeutics; Advisory / Consultancy: Chair of Scientific Advisory Board for Rain Therapeutics; Honoraria (self): Guardant; Advisory / Consultancy: Pfizer, Trovagene, Ariad, Takeda, AstraZeneca, Genentech/Roche, Ignyta, Loxo, Rain.; Research grant / Funding (institution): Ignyta, Loxo, Mirati; Licensing / Royalties: Abbott Molecular, Rain Therapeutics, GVKbio, Chugai, Loxo, Ignyta, Genentech, Ariad, Foundation Medicine, Black Diamond. M. Martinec: Research grant / Funding (institution), Shareholder / Stockholder / Stock options, Full / Part-time employment: F. Hoffman-La Roche Ltd. T. Riehl: Shareholder / Stockholder / Stock options, Full / Part-time employment: Roche. N.J. Meropol: Full / Part-time employment: Employed by Flatiron Health, Inc., an independent subsidiary of the Roche Group; Equity interest in Flatiron Health; Shareholder / Stockholder / Stock options: Roche. W. Wong: Shareholder / Stockholder / Stock options: Roche; Full / Part-time employment: Genentech. G. Crane: Shareholder / Stockholder / Stock options, Full / Part-time employment: Roche. All other authors have declared no conflicts of interest.
Resources from the same session
98P - Influence of DPYD*9, DPYD*6 and GSTP1 ile105val genetic polymorphisms on capecitabine and oxaliplatin (CAPOX) associated toxicities in colorectal cancer patients
Presenter: Ashok Varma
Session: Poster display session
Resources:
Abstract
99P - Patient-derived tumour model by new culture method leading to the precision medicine
Presenter: Norikatsu Miyoshi
Session: Poster display session
Resources:
Abstract
100P - Clinical impact and carcinogenic mechanism of NCAPG overexpression in colon cancer
Presenter: Kai-Yuan Lin
Session: Poster display session
Resources:
Abstract
101P - Combined cellular immunotherapy and chemotherapy improves clinical outcome and displays safety in the treatment of patients with colorectal cancer
Presenter: Chang Wang
Session: Poster display session
Resources:
Abstract
102P - Clinical features of anorectal cancer in patients with Crohn’s disease: Japanese single center study
Presenter: Kazuhiro Watanabe
Session: Poster display session
Resources:
Abstract
103P - Contrast-enhanced CT-based textural parameters as potential prognostic factors of survival for colorectal cancer patients receiving targeted therapy
Presenter: Yanfei Yang
Session: Poster display session
Resources:
Abstract
104P - Prognostic significance of tumour location to the oncologic outcome of colon cancer
Presenter: Sare Hosseini
Session: Poster display session
Resources:
Abstract
105P - Detection and clinical significance of circulating tumour cells in patients with rectal cancer
Presenter: Shuohui Dong
Session: Poster display session
Resources:
Abstract
106P - The risk of malignization incidence in patients with polyps and polyposis of the colon and rectum
Presenter: Yakov Ten
Session: Poster display session
Resources:
Abstract
107P - The efficacy of adjuvant chemotherapy according to the risk classification of recurrence based on the systemic inflammatory markers in patients with colorectal cancer liver metastases
Presenter: Masatsune Shibutani
Session: Poster display session
Resources:
Abstract