482P - Prevalence of EGFR mutations (EGFRm) and its subtypes in patients (pts) with resected stage I-III NSCLC: Results from EARLY-EGFR Singapore cohort

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

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.