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
97P - The role of adjuvant chemotherapy according to the status of surgical margin in rectal cancer
Presenter: Jong Hoon Lee
Session: Poster display session
Resources:
Abstract
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