Abstract 377P
Background
The increasing availability of targeted therapies has made genomic testing an integral part of management of patients with lung cancer. The guidelines are moving towards upfront molecular profiling of all advanced non-small cell lung cancers (NSCLC) with Next Generation Sequencing (NGS). Whether this translates into a clinically meaningful benefit in these patients, especially in a resource constrained country is yet to be determined.
Methods
Patients with advanced adenocarcinoma of lung who underwent tissue NGS testing after a negative EGFR, ALK and ROS1 report between April 2017 and March 2019 were included. We retrospectively analyzed the testing outcomes and any change in clinical decision making after the NGS report in such patients.
Results
Overall, NGS was done on tissue of 50 patients with advanced adenocarcinoma of lung. The median age was 58 years (range 27-82 years) and there were 31 males (58%). Most of the patients were never smokers 38(72%). The average turnaround time for the assay was 23 days (SD ± 15 days). One or more genomic alterations were found in 43 patients (86%) with most common genes affected being p53(43%), KRAS (19%), NOTCH1(13%), EGFR(6%), ROS1(4%), BRAF(8%) and HER2(8%). Seven (14%) of the patients were found to have mutations that were targetable by an FDA approved therapy and 9(18%) more patients had an off label available drug. So there was a potential for change of treatment in 16(32%) patients. Out of the 38(76%) patients who continued treatment at our institute, the NGS results led to a change in treatment in only 6(15%) patients. This was mostly due to limited availability of drugs, limited access to clinical trials and high cost of therapy.
Conclusions
NGS is an important tool in the detection of targetable genetic alterations and results could potentially alter therapy. However, it is an expensive investigation and its clinical utility is questionable in a developing country like India. Single gene testing for common mutations is both rapid and cost-effective, and change in therapy after further NGS testing is possible in a very small percentage of patients. However, it may be considered after a detailed discussion with the patient in view of limited access to clinical trials or targeted therapies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Nil.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
220P - An outcome analysis of robotassisted radical nephroureterectomy with extended template lymphadenectomy for upper tract urothelial carcinoma
Presenter: Ashwin Tamhankar
Session: Poster display session
Resources:
Abstract
221P - Comparative analysis of first-line immune checkpoint inhibitor versus carboplatin-based chemotherapy for cisplatin-ineligible metastatic urothelial carcinoma: A multicenter, retrospective real-world evidence
Presenter: Hsiang‐Lan Lai
Session: Poster display session
Resources:
Abstract
222P - Does tumor grade really improve the prognostic ability of the staging system for men with penile cancer: A SEER database analysis
Presenter: Ravi Kanodia
Session: Poster display session
Resources:
Abstract
223TiP - EV-301: A phase III trial in progress evaluating enfortumab vedotin versus chemotherapy in patients with locally advanced or metastatic urothelial carcinoma
Presenter: Daniel Petrylak
Session: Poster display session
Resources:
Abstract
230P - Olaparib maintenance therapy in patients (pts) with a BRCA1 and/or BRCA2 mutation (BRCAm) and newly diagnosed advanced ovarian cancer (OC): SOLO1 China cohort
Presenter: Lingying Wu
Session: Poster display session
Resources:
Abstract
231P - Cost-effectiveness of olaparib vs routine surveillance in the maintenance setting for patients with BRCA-mutated advanced ovarian cancer after response to first-line platinum-based chemotherapy in Singapore
Presenter: David SP Tan
Session: Poster display session
Resources:
Abstract
233P - Incorporation of correlative studies in ovarian cancers in the era of precision medicine: Assessment of accountability and utility
Presenter: Nadia Hitchen
Session: Poster display session
Resources:
Abstract
234P - Implementation of mainstream BRCA testing in epithelial ovarian cancer in a tertiary centre
Presenter: Edbert Wong
Session: Poster display session
Resources:
Abstract
235P - The efficacy of radiation therapy in ovarian carcinoma: A propensity score analysis of a population-based study
Presenter: Jian-Guo Zhou
Session: Poster display session
Resources:
Abstract
236P - Front-line maintenance therapy for platinum-sensitive ovarian cancer: What’s next PARP inhibitors?
Presenter: Han Gong
Session: Poster display session
Resources:
Abstract