1402P - Real-world routine KRAS testing practices in France for patients (pts) with advanced or metastatic (AM) non-small cell lung cancer (NSCLC): Data from the ESME cohort

Background

Sotorasib is available in France since 2019 in clinical trials and now early access program for KRAS G12C AM NSCLC pts who progressed after ≥1 treatment line. KRAS testing is recommended at metastatic stage for all non-squamous (nsq) and non-smokers squamous (sq) NSCLC. Our aim is to understand routine KRAS testing practices for AM NSCLC pts.

Methods

We performed a retrospective observational cohort study of AM NSCLC patients included in the Epidemio-Strategy and Medical Economics (ESME) Lung Cancer Database from 07/2015 to 10/2021. Pts were split in 4 subgroups: KRAS not tested; KRAS tested at any time of the disease; KRAS tested before first-line treatment (L1); KRAS tested after L1 and before L2. We analyzed 2 periods: 2015-2018 and 2019-2021, according to the date of AM diagnosis.

Results

20 181 AM NSCLC pts were included. 48.1% were tested for KRAS at any time of the disease, without evolution between 2015-2018 and 2019-2021 (48.7% and 43.5%, respectively). Among KRAS tested pts (n=9714), 74.1% were tested before L1 and 23% after L1 / before L2. KRAS and KRAS G12C were positive for 37.8% and 14.7% of pts respectively. KRAS positive pts (n=3668) were tested on tumor (72.1%), metastasis (26.6%) and blood (3%). We described the main differences in pts characteristics overall as no difference was observed between pts tested for KRAS before L1 and after L1 / before L2 Table: 1402P

Pts without data in KRAS tested and KRAS not tested cohorts respectively (1) 7 835 ; 8 485 (2) 186;286 (3) 368;445 (4) 405;387 (5) 609;500

Conclusions

Approximately half of AM NSCLC pts were not tested for KRAS, without evolution between 2015-2018 and 2019-2021.The emergence of KRAS G12C inhibitors should lead to an increase in AM NSCLC pts testing according to guidelines.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Unicancer.

Funding

The ESME Lung Cancer Database receives financial support from industrial partners (AstraZeneca, Roche, Janssen, MSD, BMS, Amgen). Unicancer manages the database (i.e. data collection, analysis and publication) independently. This study was funded by Amgen Ltd.

Disclosure

C. Audigier Valette: Financial Interests, Personal, Advisory Board: Roche, BMS, MSD, AstraZeneca, Sanofi, Janssen; Financial Interests, Personal, Invited Speaker: Pfizer. M. Pérol: Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, MSD, BMS, Lilly, Novartis, Takeda, Gritstone, Sanofi, Pfizer, Amgen, Janssen, GSK, Eisai, Ipsen; Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, MSD, BMS, Boehringer Ingelheim, Takeda, Illumina, Pfizer, Medscape; Financial Interests, Institutional, Research Grant: AstraZeneca, Roche, Takeda, Boehringer Ingelheim; Financial Interests, Personal, Steering Committee Member: Roche; Financial Interests, Personal, Other, DMSB: Roche. N. Girard: Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, MSD, Roche, Pfizer, Mirati, Amgen, Novartis, Sanofi, Gilead; Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Roche, Pfizer, Janssen, Boehringer, Novartis, Sanofi, AbbVie, Amgen, Lilly, Grunenthal, Takeda, Owkin, Leo Pharma, Daiichi Sankyo, Ipsen; Financial Interests, Institutional, Research Grant, Local: Roche, Sivan, Janssen; Financial Interests, Institutional, Funding: BMS, Leo Pharma; Financial Interests, Institutional, Research Grant: MSD; Non-Financial Interests, Officer, International Thymic malignancy interest group, president: ITMIG; Other, Family member is an employee: AstraZeneca. L. Bosquet: Financial Interests, Institutional, Full or part-time Employment, In charge of scientific projects at Unicancer, Health Data and Partnership Department: Unicancer. L. De Gunten: Financial Interests, Personal, Full or part-time Employment: Amgen SAS. G. Desamericq: Financial Interests, Personal, Full or part-time Employment: Amgen; Financial Interests, Personal, Stocks/Shares: Amgen. L. Tzala: Financial Interests, Personal, Full or part-time Employment: Amgen; Financial Interests, Personal, Stocks/Shares: Amgen. B. Allard: Financial Interests, Personal, Full or part-time Employment: Amgen SAS; Financial Interests, Personal, Stocks/Shares: Amgen SAS. D. Debieuvre: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Janssen, Pfizer, OSE Immunotherapeutics, Novartis, Sanofi Aventis, Amgen, Roche, Ipsen; Financial Interests, Personal, Invited Speaker: Gilead, Takeda; Financial Interests, Personal, Coordinating PI: Pfizer; Financial Interests, Institutional, Funding: Roche, AstraZeneca, Janssen, MSD, Pfizer, BMS, Lilly, Boehringer Ingelheim, GSK, Chugaï, Chiesi, Novartis, Takeda, Bayer, Sanofi Aventis.