Abstract 1272P
Background
In previous studies, early onset non-small cell lung (NSCLC) cancer was associated with low tobacco exposure, female gender and higher probability of harboring actionable genomic alterations (AGA). Broad hybrid NGS can identify AGA in NSCLC patients (pts) deemed driver negative by routine molecular analysis.
Methods
EOLUNG is a multicenter, prospective, non-interventional study to investigate the clinicopathological and molecular characteristics of young pts, ≤50 years-old (yo) at diagnosis, with NSCLC. After obtaining informed consent, the somatic and germline molecular profile was assessed using FoundationOne CDx (FOne) and a NGS custom panel, respectively. This is a preliminary report of the somatic tumor testing.
Results
114 pts were included from June 2018 to March 2021. Fifty pts were women (43.9%). Most pts were Caucasian (92.1%). Median age at diagnosis: 46 yo (range 28-50). Most pts (93.8%) had ECOG PS 0-1. Only 20.2% were never smokers, while 51.8% were current and 27.2% former smokers. The most common histology was adenocarcinoma (76.3%), followed by squamous cell carcinoma (11.4%) and undifferentiated NSCLC (12.2%). Sixty-six pts (57.9%) had stage IV at diagnosis and 72.8% recieved palliative treatment. Single gene testing in stage IV was performed in 94% of pts and detected AGA in 42 pts (36.8%), including 14 EGFR mutation (21.2%), 14 ALK fusion (21.2%), 2 RET fusion (3%) and 1 BRAF V600E mutation (1.5%). Patients harboring AGA were more likely to be women and never smokers. Fifty-nine pts had sufficient tumor sample for FOne and in 44 (74.5%) a report is already available. All tumors were microsatellite stable and median TMB was 10 mut/Mb (range 0-54). TMB was low (0-5 mut/Mb) in 29.5%, intermediate (6-19 mut/Mb) in 34.1% and high (≥20 mut/Mb) in 20.5%. Not previously known AGA were detected in 4 pts (2 EGFR mutation, ROS1 and RET rearrangement in 1 patient each). Further details regarding treatment outcomes and updated molecular analysis will be presented.
Conclusions
In this study, early onset NSCLC pts is a heterogenous population with significant tobacco exposure. Molecular testing using FOne CDx in this setting was helpful to identify undetected AGA.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Institut Català d'Oncologia.
Funding
GECP, SEOM & Roche.
Disclosure
M. Jove Casulleras: Financial Interests, Personal, Other, Congress travel and accommodations/conference: Takeda; Financial Interests, Personal, Other, Congress travel and accommodation: Roche; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Other, Congress travel and accommodation: MSD. E. Carcereny: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Other, Travel Accommodation: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Other, Travel accommodation: Roche; Financial Interests, Personal, Other, Travel accommodation: Takeda; Financial Interests, Personal, Invited Speaker, Travel accommodation: Pfizer. T. Moran: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb. M. Domenech Vinolas: Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: AstraZeneca. R. Palmero: Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: Guardant Health; Financial Interests, Personal, Invited Speaker: Roche. N. Vilariño: Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Other, Travel, accommodation and expenses: Roche; Financial Interests, Personal, Other, Travel, accommodation and expenses: Lilly; Financial Interests, Personal, Other, Travel, accommodation and expenses: Pfizer. J.C.C. Ruffinelli: Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Pierre Fabre; Financial Interests, Personal, Other, Travel, Accommodation expenses: Merck; Financial Interests, Personal, Other, Travel, Accommodation expenses: Novartis; Financial Interests, Personal, Other, Travel Accommodation expenses: Bristol Myers Squibb. A. Teule: Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Other, Travel grants: Novartis; Financial Interests, Personal, Invited Speaker: Ipsen; Financial Interests, Personal, Advisory Board: Ipsen; Financial Interests, Personal, Other, Travel grants: Ipsen; Financial Interests, Personal, Invited Speaker: AAA; Financial Interests, Personal, Advisory Board: AAA; Financial Interests, Personal, Other, Travel Grants: AAA; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Other, Travel Grants: Pfizer; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Other, Travel Grants: AstraZeneca. E. Nadal: Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Merck Serono; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: Merck Serono; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Invited Speaker: Amgen; Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Takeda; Financial Interests, Personal and Institutional, Other, Research funding: Roche; Financial Interests, Personal and Institutional, Other, Research funding: Pfizer; Financial Interests, Personal and Institutional, Other, Research funding: Merck Serono; Financial Interests, Personal and Institutional, Other, Research funding: Bristol Myers Squibb. All other authors have declared no conflicts of interest.