1292P - A national real-world analysis of ROS1+ metastatic non-small cell lung cancer patients management (explore ALK, cohort 2, GFPC 03-2019)

Background

ROS1 translocation (ROS1+) is a rare sub-group of non-small cell lung cancer (NSCLC), found in 1 to 2% of NSCLC patients. There are few data of the management and outcomes of these patients in real world setting.

Methods

The objective of this study was to assess management and outcomes of a national cohort of ROS1 NSCLC patients. The analysis included all ROS1+ NSCLC pts managed in 28 centers between June 1, 2013 (date of access in France) and November 13, 2023. Patient characteristics, duration on different treatments (DOT), according to lines of treatment, progression-free survival assessed locally (rwPFS), overall survival (OS), response rate and tolerance were assessed based on medical files.

Results

The analysis included 141 ROS1+ advanced NSCLC pts: 58% women, 86.5% no or former smokers, 97.8 % with adenocarcinomas, median age 58 (30-91) years, 29 (20.6%) with local or locally advanced stages at diagnosis and 34 (24%) with brain metastases at diagnosis. With a median follow up of 33.3 months (IC 95% 23.6-38.2), the median number of systemic treatments was 2 (± 1.88) and 98.6%, 63.8% and 36.9% received at least one (L1), 2 (L2) or 3 and more (L3+) lines. In L1, median rwPFS of pts receiving Crizotinib, 88 (63%), and pts receiving platinum based chemotherapy 40 (28.3%), were 16.9 (IC 95% 12.1-27.1) and 11.9 (IC 95% 9.7-17.1) months respectively. In L2, median rwPFS of pts receiving Crizotinib, 30 (21.2%) and Lorlatinib, 33 (23.4%) were 25.6 (IC95% 15.9-55.1) and 26.5 (IC 95% 7.8-35.6) months respectively. In L3, median rwPFS of pts receiving chemotherapy, 19 (13.5%), and pts receiving Lorlatinib, 15 (10.6%), were 8.1 (95% IC 3.4-10) and 28.5 (IC 95% 3.8-68.5) months. The median OS was 81.7 months (IC 95% 62,9- 104), 55.9 (18.2-NR) and 94.2 (65.2-104) in patients with and without cerebral métastasis at the diagnosis. Sides effects resulted in treatment interruption for 21 (14.9%) in L1.

Conclusions

This large real-world, cohort of unselected advanced ROS1+ NSCLC pts confirm the good prognostic of this disease. A more complete analysis of therapeutic sequences and clinical modalities of progression will be discussed during the congress.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

GFPC.

Funding

Roche, Takeda, Pfizer.

Disclosure

G. Rousseau Bussac: Financial Interests, Personal, Speaker, Consultant, Advisor: Takeda; Non-Financial Interests, Personal, Non financial benefits: Pfizer. F. Guisier: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, BMS, MSD, Roche, Sanofi, Janssen, Pfizer, Takeda; Financial Interests, Institutional, Research Grant: Pfizer, Roche, Takeda. R. Veillon: Financial Interests, Personal, Speaker, Consultant, Advisor: Takeda, Pfizer. H. Doubre: Financial Interests, Personal, Invited Speaker: Leo Pharma; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Institutional, Local PI: Bristol Myers Squibb Foundation, Merck. A.B. Cortot: Non-Financial Interests, Personal, Non financial benefits: Pfizer; Financial Interests, Personal, Speaker, Consultant, Advisor: Roche, Takeda. L. Moreau: Financial Interests, Personal, Speaker, Consultant, Advisor: Pfizer, Roche; Non-Financial Interests, Personal, Non financial benefits: Roche. T. Pierret, S. Hominal: Non-Financial Interests, Personal, Non financial benefits: Pfizer. L. Falchero: Financial Interests, Personal, Speaker, Consultant, Advisor: Pfizer, Roche. G. Justeau: Non-Financial Interests, Advisory Role: BMS. C. Ricordel: Financial Interests, Personal, Advisory Board: Roche, Takeda, MSD, BMS, Janssen, Sanofi, Astrazeneca. H. Morel: Non-Financial Interests, Personal, Non financial benefits: Takeda. K. Amrane, S. Martinez, P.A. Renault: Non-Financial Interests, Personal, Non financial benefits: Pfizer, Roche. D. Moreau: Non-Financial Interests, Personal, Non financial benefits: Roche. M. Marcq: Non-Financial Interests, Personal, Non financial benefits: Pfizer, Roche, Takeda. R. Descourt: Financial Interests, Personal, Speaker, Consultant, Advisor: Pfizer, Roche, Takeda. L. Greillier: Financial Interests, Personal, Advisory Board: AbbVie, AstraZeneca, BMS, MSD, Novartis, Sanofi, Takeda, Roche; Financial Interests, Personal, Invited Speaker: Lilly, Pfizer; Financial Interests, Institutional, Local PI: AstraZeneca, AbbVie, BMS, MSD, Novartis, Takeda, Pfizer, Roche, PharmaMar; Financial Interests, Institutional, Coordinating PI: Sanofi. All other authors have declared no conflicts of interest.