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
458P - Mutation tracking in circulating tumour DNA predicts relapse in completely resected EGFR-mutated NSCLC
Presenter: Martin Filipits
Session: Poster display session
Resources:
Abstract
460P - Mendelian randomization study showed no causality between metformin use and lung cancer risk
Presenter: Jiayi Shen
Session: Poster display session
Resources:
Abstract
461P - Blood trace minerals and lung cancer: A Mendelian randomization study
Presenter: Wei Xian
Session: Poster display session
Resources:
Abstract
463P - Prediction of invasiveness in lung adenocarcinoma using machine learning algorithm based on 3D-CT imaging
Presenter: Yusuke Saeki
Session: Poster display session
Resources:
Abstract
459P - Fish intake, dietary polyunsaturated fatty acids, and lung cancer: systematic review and dose-response meta-analysis of 1.7 million men and women
Presenter: Chao Cao
Session: Poster display session
Resources:
Abstract
462P - Usefulness for prevention of postoperative cerebrovascular complications in patients with lung cancer using carotid ultrasonography
Presenter: Sadanori Takeo
Session: Poster display session
Resources:
Abstract
468P - Histological type analysis of 10-year follow-up of WJTOG0105: A phase III study comparing second- and third-generation regimens with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer
Presenter: Masahiro Tsuboi
Session: Poster display session
Resources:
Abstract
469P - Comparison of combined chemoradiotherapy regimens; Paclitaxel plus carboplatin and cisplatin plus etoposide for locally advanced non-small cell lung cancer: A randomised phase III trial
Presenter: Alper Ata
Session: Poster display session
Resources:
Abstract
472P - Integration of expression rate and absolute cell counts of PD-1+ stromal tumour-infiltrating lymphocytes: Prognostic significance in esophageal squamous cell carcinoma
Presenter: Qingkun Song
Session: Poster display session
Resources:
Abstract
467P - The free-circulating mtDNA copies number in plasma of patients with NSCLC
Presenter: Olga Bulgakova
Session: Poster display session
Resources:
Abstract