Abstract 719P
Background
The utility of Next Generation Sequencing (NGS) in patients of non-small cell lung cancer (NSCLC) has led to an exponential increase in the identification of targetable gene alterations. 60-65% of NSCLC patients from western datasets and 80% of patients from Asian datasets report identification of driver gene alterations, however, Indian NGS data was lacking. We present the largest Indian NGS data reporting the frequency of driver gene alterations, treatment pattern, and survival outcomes in patients of NSCLC.
Methods
This retrospective single-center study conducted between May’19 and Dec’23 included histologically confirmed NSCLC cases with NGS testing done on tissue or liquid biopsy samples at the time of diagnosis. All cases were discussed in the thoracic medical oncology disease management group, and the study was approved by the Institutional Ethics Committee.
Results
Data of 1230 patients was analyzed. Median age was 59 years (IQR,51-66), 65.3% (n=803) were males, 34.6% (n=426) had a history of smoking, and 78.1% (n=961) had an adenocarcinoma histology. NCCN approved driver gene alterations were picked up in 64.8% (n=797) cases. EGFR, ALK, ROS1, ERBB2, MET, RET, NTRK, BRAF and KRAS gene alterations were seen in 33.7% (n=414), 7.6% (n=94), 2.4% (n=29), 6.1% (n=75), 1.9% (n=23), 2.2% (n=22), 0.7% (n=8), 3.3% (n=40), and 9.6% (n=118) cases respectively. 62.1% (n=495/797) driver positive patients could receive targeted therapy, and 21.7% (n=94/433) driver negative patients could receive immunotherapy. With the receipt of targeted therapy, median OS of driver positive patients was 31.9 months (95%CI,26.7-37.2) versus 8.3 months (95%CI,6.5-10.2, p<0.001) without. Similarly, in driver negative patients, median OS with the receipt of immunotherapy was 16.4 months (95%CI,12.5-20.4) versus 11.4 months (95%CI,9.2-13.6, p=0.003) without.
Conclusions
NGS testing is imperative in patients of NSCLC due to high rates of detection of targetable gene alterations. Indian NSCLC NGS data is unique compared to Western and Asian counterparts. Adequate efforts must be undertaken to increase the utility of targeted and immunotherapy agents.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.