Abstract 1414P
Background
The aim of this study was to observe the concurrent genetic profiles of EGFR-mutated advanced Chinese non-small cell lung cancer (NSCLC), as well as to analyze the effects of diverse concurrent genetic alterations on the prognosis in EGFR-mutated NSCLC treated in first-line with EGFR-TKI.
Methods
The CAPTRA-Lung (NCT03334864) database was used to retrieve 307 patients with advanced EGFR-mutated NSCLC between January 1, 2018 and January 1, 2022 in our institution. Of those, 103 patients were detected by next-generation sequencing (NGS) and the results showed other concurrent genetic alterations. We divided them into two cohorts: those who were sequenced with NGS at baseline were included in cohort 1, and those who received NGS after progression to first-line therapy were contained in cohort 2. The follow-up deadline was October 1, 2022.
Results
The following genes are found to be most frequent in the entire cohort: TP53 mutation (n = 64, 62.14%), EGFR amplification (n = 14, 13.59%), KRAS mutation (n = 13, 12.62%), PIK3CA mutation (n = 13, 12.62%), and DNMT3A mutation (n = 13, 12.62%). Most of the TP53 mutations have been identified in exons 5 (16/64), 6 (9/64), 7 (10/64), 8(9/64), etc. For KRAS mutations, G12V (4/13) and G12S (3/13) were the most common mutation types, and E545K (5/13) and H1047R (2/13) were the most frequently alterations observed in PIK3CA. Cohort 1 constituted 68 patients (mean [SD] age, 60.93 [9.051] years; 55.9% female). Multivariate analysis demonstrated that alterations in TP53 (HR 1.946, 95% CI 1.112-3.403; P = 0.020) and MET (HR 3.581, 95% CI 1.070-11.992; P = 0.039) were independently correlated to poor progression-free survival (PFS). Cohort 2 encompassed 35 patients (mean [SD] age, 56.80 [8.741] years; 71.4% female). Multifactorial analysis showed that TP53 mutation (HR 2.198, 95% CI 1.006-4.803; P = 0.048) and RB1 mutation (HR 8.798, 95% CI 1.604-48.269; P = 0.012) were independent risk factors for PFS with first-line targeted therapy.
Conclusions
This research added to the evidence that co-alterations such as TP53, MET, and RB1 are prospective prognostic biomarkers in NSCLC patients treated with EGFR-TKI.
Clinical trial identification
NCT03334864.
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.
Resources from the same session
1464P - Impact of age on the benefit of immunotherapy for metastatic squamous cell lung cancer: An NCDB database analysis
Presenter: Zhonglin Hao
Session: Poster session 20
1465P - Clinical impact of proton pump inhibitor on the therapeutic outcome of non-small cell lung cancer patients with PD-L1 TPS ≥50% receiving pembrolizumab monotherapy versus immune checkpoint inhibitor plus chemotherapy: A retrospective multicenter cohort study
Presenter: Hayato Kawachi
Session: Poster session 20
1467P - Combination therapy of envafolimab and suvemcitug with chemotherapy in patients with non-small cell lung cancer (NSCLC): Results from a phase II clinical trial
Presenter: Chunjiao Wu
Session: Poster session 20