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
592P - Treatment patterns and outcomes in patients with advanced non-small cell lung cancer with MET exon 14 skipping alterations in China
Presenter: Hanxiao Chen
Session: Poster Display
Resources:
Abstract
593P - MET TKIs in Asian patients (pts) with MET exon 14 skipping NSCLC: A matching-adjusted indirect comparison (MAIC)
Presenter: E-e Ke
Session: Poster Display
Resources:
Abstract
594P - The treatment pattern and clinical outcome in NSCLC patients with MET alteration: A retrospective real-world analysis in China
Presenter: Yongfeng Yu
Session: Poster Display
Resources:
Abstract
595P - Durable efficacy of zenocutuzumab, a HER2 x HER3 bispecific antibody, in advanced NRG1 fusion-positive (NRG1+) non-small cell lung cancer (NSCLC)
Presenter: Koichi Goto
Session: Poster Display
Resources:
Abstract
596P - Repotrectinib in patients (pts) from Asia and China with ROS1 fusion-positive (ROS1+) non-small cell lung cancer (NSCLC): Results from the phase I/II TRIDENT-1 trial
Presenter: Ross Soo
Session: Poster Display
Resources:
Abstract
597TiP - A phase I/II study to evaluate the safety and anti-tumor activity of JIN-A02 in patients with EGFR TKI-refractory, EGFR-mutant advanced NSCLC
Presenter: Sun Min Lim
Session: Poster Display
Resources:
Abstract
598TiP - Exploration of aumolertinib in first-line treatment for advanced non-small cell lung cancer patients of performance status 3 with EGFR mutations (19del and L858R)
Presenter: Haiyi Deng
Session: Poster Display
Resources:
Abstract
599TiP - A prospective study of savolitinib plus docetaxel in pretreated EGFR/ALK/ROS1/METex14m-wildtype advanced NSCLC patients with MET overexpression (FirstMET)
Presenter: Shuting Zhan
Session: Poster Display
Resources:
Abstract
600TiP - Phase III study of telisotuzumab vedotin (Teliso-V) vs docetaxel in pretreated c-Met overexpressing EGFR wildtype (WT) non-squamous (NSQ) locally advanced/metastatic non-small cell lung cancer (a/mNSCLC)
Presenter: Junko Tanizaki
Session: Poster Display
Resources:
Abstract
601P - Pembrolizumab in patients of Chinese descent with microsatellite instability-high/mismatch repair deficient advanced solid tumors: KEYNOTE-158
Presenter: Xiaohua Wu
Session: Poster Display
Resources:
Abstract