Abstract 681P
Background
A prospective comprehensive genomic sequencing initiative for advanced non-squamous non-small-cell lung cancer (NSCLC) patients is being conducted territory-wide in Hong Kong. By leveraging state-of-the-art genomic technologies, this initiative aims to advance our understanding of the genomic landscape of NSCLC in a predominantly Asian patient population.
Methods
Patients enrolled were ≥18 years old and had histologically confirmed stage IV non-squamous NSCLC since January 2021. Blood was collected for ctDNA extraction, and formalin-fixed, paraffin-embedded tumor tissue was collected from primary and/or metastatic sites. All patients recruited underwent comprehensive target panel next-generation sequencing (cTP-NGS) using Foundation One CDx and/or Foundation One Liquid CDx. The study's enrollment and data collection is ongoing.
Results
To date, we have enrolled 815 patients, of whom 60.6% were male. The median age at the time of cTP-NGS was 67 (range 32-94). Amongst our current recruits, 48% (n=391) harbored druggable mutations. The three most prevalent mutations were EGFR L858R/Exon 19 deletion (30%), KRAS G12C (5%), and ERBB2 oncogenic mutations (4%). In our cohort, 45 (5.5%) patients harbored gene fusions. ALK fusion was the most prevalent structural rearrangement, prevalent in 2% (n=18) of the cohort, followed by RET (1.5%). The median tumor mutational burden (TMB) for our cohort was 3.62 (IQR: 1.26-7.57), and 19% (n=153) had a high TMB. TP53 was the most frequently mutated gene (n=482,59%). Overall, 44% (n=210) of the patients with a TP53 mutation also had an EGFR co-mutation, specifically EGFR L858R:TP53 splice site (n=8,2%). Among our patient cohort, 424 patients (52%) had a follow-up period of > 6 months. The median progression-free and overall survival were 10.5 and 22.8 months, respectively. 34% of patients received target treatment, 26% immunotherapy, and 25% chemotherapy as the first line of treatment.
Conclusions
Overall, our prospective study demonstrates the importance of genomic profiling in guiding precision medicine in advanced NSCLC. Providing valuable insights into the mutational landscape of NSCLC. These findings have significant clinical implications in Hong Kong and globally.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Innovation and Technology Commission (ITC)–Hong Kong under the Partnership Research Programme scheme (PRP/067/20FX).
Disclosure
All authors have declared no conflicts of interest.