Abstract 482P
Background
Identification of EGFRm in early-stage NSCLC determines the prognosis and is predictive of response to targeted therapy. EARLY-EGFR (NCT04742192) is the first real-world study describing the prevalence of EGFRm and treatment patterns in pts with early-stage NSCLC.
Methods
This prospective, non-interventional study consecutively enrolled pts with surgically-resected stage IA-IIIB non-squamous NSCLC from 14 countries across Asia, Latin America and the Middle East and Africa. [EJ1] [NP[2] Here, we describe the prevalence of EGFRm and its subtypes, clinico-demographics and treatment patterns for patients enrolled from Aug 2021 to Sep 2022 in the Singapore cohort.
Results
A total of 71 pts were enrolled (mean±SD age 67.3±8.5 yrs); 54.9% were females and 66.2% were never smokers. Most pts had adenocarcinoma (98.6%), stage I NSCLC (73.2%), right lung tumour (64.8%), T2a/b stage (52.1%) and pN0 (81.7%). About 83% (38/46) of the cases were discussed in a multidisciplinary team (MDT) meeting (pre-operative: 55.3%, post-operative: 31.6%, both: 13.2%). The EGFRm prevalence was 63.8% (44/69). The EGFR subtypes included exon-19 del (29, 65.9%), exon 21-L858R (11, 25.0%) and uncommon mutations (4, 9.1%). Of 15 pts with PD-L1 test report, 8 had PD-L1>1%; 5 of them had EGFRm. Overall, 76.1% (54/71) underwent only surgical resection without any adjuvant treatment. Adjuvant therapy was planned in 16 pts (22.5%): IA (1), IB (04), IIA (2), IIB (5), IIIA (3), IIIB (1). Of the 48 pts with stage IB-IIIB, 15 (31.3%) were prescribed systemic therapy (ST); targeted therapy was planned in 2 pts. No pt received neo-adjuvant ST. Table: 482P
Prevalence of EGFRm
Characteristics | N=71, n (%) | Mutation rate | |||
EGFRm (N=44), n | EGFR wild type (N=25), n | Mutation rate (%) | |||
Age (yrs) | <60 | 14 (19.7) | 10 | 3 | 76.9 |
60-80 | 54 (76.1) | 31 | 22 | 58.5 | |
>80 | 3 (4.2) | 3 | 0 | 100 | |
Gender | Female | 39 (54.9) | 25 | 13 | 65.8 |
Male | 32 (45.1) | 19 | 12 | 61.3 | |
Histology | Adenocarcinoma | 70 (98.6) | 43 | 25 | 63.2 |
Others | 01 (1.4) | 1 | 0 | 100 | |
Smoking* | Current | 04 (5.6) | 2 | 1 | 66.7 |
Former | 20 (28.2) | 9 | 11 | 45.0 | |
Never | 47 (66.2) | 33 | 13 | 71.7 | |
Stage (AJCC 8th edi.) | IA | 23 (32.4) | 15 | 8 | 65.2 |
IB | 29 (40.8) | 17 | 12 | 58.6 | |
IIA | 3 (4.2) | 1 | 1 | 50.0 | |
IIB | 09 (12.7) | 5 | 3 | 62.5 | |
IIIA | 06 (8.4) | 5 | 1 | 83.3 | |
IIIB | 01 (1.4) | 1 | 0 | 100.0 |
Two pts failed EGFR test *p = 0.051: comparison between current and former vs. never smoker Unknown/missing data not included
Conclusions
Our study reports a high prevalence of EGFRm (63.8%). Of 29 and 19 pts with stage IB and II-III NSCLC, ST was planned in 4 and 9 pts, respectively, highlighting the need to comply with international guidelines. Our data calls for biomarker profiling of early-stage NSCLC to ensure appropriate management through MDT.
Clinical trial identification
NCT04742192.
Editorial acknowledgement
Medical writing support was provided by Prajakta Nachane (M. Pharm) of Fortrea Scientific Pvt Ltd funded by AstraZeneca FZ LLC in accordance with GPP 2022 guidelines.
Legal entity responsible for the study
AstraZeneca International.
Funding
AstraZeneca International.
Disclosure
P.L. Chia: Other, Personal, Advisory Board: AstraZeneca, Merck, Amgen, Pfizer, Bayer; Financial Interests, Personal, Other, Honoraria for symposium: AstraZeneca, Lung Cancer Consortium Singapore; Financial Interests, Institutional, Research Funding: AstraZeneca. J.T. Kit Chung: Financial Interests, Personal, Speaker, Consultant, Advisor, Advisory and Consultancy with AstraZeneca, BMS, MSD: AstraZeneca, BMS, MSD. A. Asmat: Financial Interests, Personal, Other, Honorarium from MSD for participation in an early stage NSCLC Expert Input Forum in August 2023: MSD. R. Huggenberger: Financial Interests, Personal, Full or part-time Employment, I am an employee of AstraZeneca: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca, Innate Pharma, Chinook Therapeutics, Adaptimmune Therapeutics, CStone Pharmaceuticals, Allogene Therapeutics, Imugene Limited, Swedish Orphan Biovitrium, Cullinan Oncology, Blueprint Medicines, GSK, Gritstone Bio, Compugen, Arcutis Biotherapeutics, Syndax Pharmaceuticals, Eli Lilly. A. Verma: Other, Personal, Full or part-time Employment: AstraZeneca. R.A. Soo: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Bayer, BMS, Lily, Merck, Novartis, Pfizer, Roche, Taiho, Takeda, Yuhan, Thermo Fisher, Janssen, Merck Serono, Puma Biotech; Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim; Financial Interests, Institutional, Research Grant: AstraZeneca, Boehringer Ingelheim.
Resources from the same session
485P - LDCT lung cancer screening of never-smokers meta-analysis subgroup analysis: Adenocarcinoma is the highly predictive histology identified in never-smokers
Presenter: Sai-Hong Ou
Session: Poster Display
Resources:
Abstract
486P - Fiscal feasibility and implications of integrating lung cancer screening into Hong Kong’s healthcare system
Presenter: Herbert Ho Fung Loong
Session: Poster Display
Resources:
Abstract
487P - Evaluating the performance of the USPSTF lung cancer screening guidelines in an Asian population of lung cancer patients
Presenter: Jian Wei Tan
Session: Poster Display
Resources:
Abstract
488P - Pulmonary ground glass opacity lesions: Immune ecosystem and its clinical relevances of early-stage lung adenocarcinoma
Presenter: Shensi Shen
Session: Poster Display
Resources:
Abstract
489TiP - BGB-LC-202 (NCT05577702): Phase II Umbrella study of tislelizumab (TIS) monotherapy and TIS-based immunotherapy combinations +/- chemotherapy (CT) as neoadjuvant treatment in Chinese patients (pts) with resectable stage II to IIIA non-small cell lung cancer (NSCLC)
Presenter: Wentao Yu
Session: Poster Display
Resources:
Abstract
491P - Furmonertinib as adjuvant therapy for elderly patients in resected EGFR-mutated non-small cell lung cancer: A double-center, real-world experience
Presenter: Ziheng Wu
Session: Poster Display
Resources:
Abstract
492P - Penpulimab-based combination neoadjuvant/adjuvant therapy for patients with resectable locally advanced non-small cell lung cancer: Preliminary results from a phase II study (ALTER-L043)
Presenter: Changli Wang
Session: Poster Display
Resources:
Abstract
493P - The prognostic value of 4L lymph node dissection in left-sided operable non-small cell lung cancer: A systematic review and meta-analysis
Presenter: Lei Peng
Session: Poster Display
Resources:
Abstract
495P - Intrinsic STING of CD8+T cells regulates self-metabolic reprogramming and exerts anti-tumor effects
Presenter: Qiuli Xu
Session: Poster Display
Resources:
Abstract
496P - Fruquintinib plus sintilimab in patients (pts) with advanced non-small cell lung cancer (NSCLC) with PD-L1-positive expression: A multicenter, single-arm phase II study
Presenter: Shun Lu
Session: Poster Display
Resources:
Abstract