Abstract 598P
Background
A number of clinical trials with perioperative targeted therapy for oncogene-driven for early-stage non-small cell lung cancer (NSCLC) are ongoing. In this study, we assessed the frequency and characteristics of actionable genomic alterations (AGAs) in early-stage NSCLC as part of a multicenter large-scale prospective genomic screening study in Japan (LC-SCRUM-Advantage/MRD).
Methods
Patients with operable clinical stage I to III NSCLC were eligible for this study. Preoperative biopsy tumor samples were collected before surgery. AmoyDx Pan Lung Cancer PCR Panel (multi-PCR panel) was performed for a measurement of AGAs including EGFR, ALK, ROS1, KRAS, BRAF, HER2, RET, MET and NTRK genes. Surgical tumor samples were also collected after surgery, and used for analysis for 50 gene alterations using a next-generation sequencing system, Oncomine Precision Assay (OPA).
Results
Between August 2022 and July 2024, a total of 330 patients were enrolled in LC-SCRUM-Advantage/MRD. Of the 294 evaluable NSCLC patients at this analysis, the median age 72 years (37-88), 108 patients were female, clinical stage I/II/III: 168/77/49, Adenocarcinoma (Ad)/Squamous cell carcinoma (Sq)/Others: 200/69/25. A total of 134 (46%) of patients had AGAs, 92 (31%) EGFR mutations, 14 (5%) MET ex 14 skipping, 11 (4%) KRAS G12C, 10 (3%) HER2 ex20ins, 3 (1%) ALK fusion, 2 RET fusion, and BRAF V600E, NTRK fusion were each one patient. In a comparison of patients with the AGAs/non-AGAs, female: 54/22%, non-smoker: 45/14%, Ad: 91/50% and stage I: 67/46% tended to be higher in AGAs and no AGAs observed in Sq patients.
Conclusions
The frequency of AGAs in early-stage NSCLC was similar to that previously being reported for advanced NSCLC. Genomic screening for early-stage NSCLC could help to detect AGAs particularly in non-Sq NSCLC.
Clinical trial identification
UMIN000048977.
Editorial acknowledgement
Nothing
Legal entity responsible for the study
The authors.
Funding
National Cancer Center Research and Development Fund 28-A-6.
Disclosure
Y. Zenke: Financial Interests, Personal, Invited Speaker: AstraZeneca, Lilly, Chugai, Boehringer Ingelheim, Ono Pharmaceutical, Bristol Meyers Squibb, Takeda pharmaceutical, Taiho pharmaceutical, MSD, Novartis, Nippon-kayaku, Amgen, Kyowa-Hakko Kirin; Financial Interests, Personal, Advisory Board: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: AstraZeneca, MSD, Merck, Daiichi Sankyo, AMGEN. K. Yoh: Financial Interests, Personal, Invited Speaker: AstraZeneca, Bristol Myers Squibb, Chugai, Lilly, Amgen, Takeda, Ono Pharmaceutical, MSD, Daiichi Sankyo, Kyowa Kirin; Financial Interests, Personal, Advisory Board: AbbVie, Boehringer Ingelheim; Financial Interests, Institutional, Local PI: AstraZeneca, Lilly, Daiichi Sankyo, AbbVie, Taiho Pharmaceutical, MSD, Takeda, Boehringer Ingelheim, Chugai, Amgen, ArriVent Biopharma; Financial Interests, Personal, Steering Committee Member: AstraZeneca. H. Saijo: Financial Interests, Personal, Speaker’s Bureau: AstraZeneca. H. Izumi: Financial Interests, Institutional, Local PI: Amgen Inc, Eisai, AbbVie; Financial Interests, Personal and Institutional, Local PI, Invited Speaker: Ono Pharmaceutical Company, AstraZeneca; Financial Interests, Personal, Other, Invited Speaker: Chugai Pharmaceutical Co., Merck Biopharma Co., Takeda Pharmaceutical Co.; Financial Interests, Personal, Other, Advisory board: Amgen. S. Matsumoto: Financial Interests, Personal, Invited Speaker: Merck Biopharma, Eli Lilly, AstraZeneca, Chugai, Novartis, Guardant Health, Amgen, Takeda, Daiichi Sankyo; Financial Interests, Institutional, Local PI: Merck Biopharma, Janssen Pharmaceutical K.K., MSD. T. Sakai: Financial Interests, Personal, Invited Speaker: AstraZeneca, Chugai Pharmaceutical, MSD, Daiichi Sankyo, Novartis, Taiho, Amco, OLYMPUS, Merck; Financial Interests, Institutional, Local PI: Amgen, Daiichi Sankyo, Astellas, Merck; Financial Interests, Institutional, Research Grant: NEC. H. Udagawa: Financial Interests, Personal, Speaker’s Bureau: Chugai, TAIHO, Daiichi Sankyo, Novartis, AstraZeneca, MSD; Financial Interests, Institutional, Local PI: Amgen, TAIHO, MSD; Financial Interests, Institutional, Research Funding: Takeda Pharmaceutical, Boehringer Ingelheim. S. Umemura: Financial Interests, Institutional, Research Grant: Taiho Pharmaceutical, Gilead, MSD, Lilly, Daiichi Sankyo. M. Tsuboi: Financial Interests, Personal, Invited Speaker, Lecture: Johnson & Johnson Japan; Financial Interests, Personal, Advisory Board, Lectures, Advisory boards: AstraZeneca KK, Chugai Pharmaceutical CO.,LTD, MSD; Financial Interests, Personal, Invited Speaker, Lectures: Eli Lilly Japan, Bristol Myers Squibb KK, Taiho Pharma, Medtronic Japan, Ono Pharmaceutical CO.,LTD, Daiichi Sankyo company limited; Financial Interests, Personal, Advisory Board, Advisory boards: Novartis, MiREXS; Financial Interests, Institutional, Research Grant: Boehringer Ingelheim Japan, MSD, AstraZeneca KK, Ono Pharmaceutical CO.,LTD, Bristol Myers Squibb KK, Novartis, MiRXES; Financial Interests, Personal, Steering Committee Member: MSD, AstraZeneca, Novartis; Financial Interests, Institutional, Steering Committee Member: Eli Lilly Japan. K. Goto: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical Co., Ltd., Amgen K.K., Takeda Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Amgen Inc., Amoy Diagnosties Co., Ltd., AstraZeneca K.K., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb K.K., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Guardant Health Inc., Merck Biopharma Co., Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Thermo Fisher Scientific K.K., Taiho Pharmaceutical Co., Ltd., SYNEOS Health Clinical K.K., Life Technologies Japan Ltd., Bayer U.S., Riken Genesis Co., Ltd.; Financial Interests, Personal, Advisory Board: Bayer HealthCare Pharmaceuticals Inc., Janssen Pharmaceutical K.K., Haihe Biopharma Co., Ltd.; Financial Interests, Personal and Institutional, Funding: Amgen Inc., Amgen K.K., AstraZeneca K.K., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Haihe Biopharma Co., Ltd., Ignyta,Inc., Janssen Pharmaceutical K.K., Kissei Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Loxo Oncology, Inc., Medical & Biological Laboratories Co., Ltd., Merck Biopharma Co., Ltd., Merus N.V., MSD K.K., Ono Pharmaceutical Co., Ltd., Pfizer Japan Inc., Sysmex Corporation., Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Turning Point Therapeutics,Inc., Amgen Astellas BioPharma K.K., Bayer Yakuhin, Ltd., Blueprint Medicines Corporation., Life Technologies Japan Ltd., NEC Corporation., Novartis Pharma K.K., Craif Inc., Pfizer R&D Japan G.K., LSI Medience Corporation., Precision Medicine Asia Co., Ltd., Riken Genesis Co., Ltd., Xcoo, Inc.; Non-Financial Interests, Personal, Member: American Society of Clinical Oncology, The Japan Lung Cancer Society, Japanese Society of Medical Oncology, The Japanese Cancer Association. All other authors have declared no conflicts of interest.