Abstract 1339P
Background
KRAS is the most frequently mutated isoform of the rat sarcoma proto-oncogene in NSCLC. The G12C mutation accounts for ∼40% of KRAS mutations and occurs in ∼13% of lung adenocarcinoma. The purpose of this largest US-based cohort study reported to date is to provide real-world evidence on clinicopathological characteristics and treatment patterns in NSCLC KRAS G12C patients in the FH-FMI CGDB.
Methods
We performed a retrospective study of adult advanced NSCLC patients who were treated in the Flatiron Health network between January 2011–March 2019 with a KRAS G12C mutation detected via FoundationOne® tumor sequencing as part of routine, real-world care. Genomic alterations were detected via next-generation sequencing (NGS). Clinicopathological characteristics and treatment patterns were described using de-identified EHR data.
Results
743 advanced NSCLC KRAS G12C patients were identified; 61.1% were female, and the average age (SD) was 67.1 (9.6) years. The majority (97%) were former or current smokers. 69% had advanced or metastatic cancer at initial diagnosis; non-squamous cell carcinoma (91%) was the most common histology. In the advanced or metastatic setting, 149 (20%) received no therapy, 594 (80%) had at least one line, 301 (41%) had at least two lines, and 151 (20%) had three or more lines of therapy. Limiting to patients with NGS testing prior to or up to 21 days after the start of a line, the most common treatments were platinum-based therapies with/without PD-1/PD-L1 therapy and PD-1/PD-L1 monotherapy in first-line (69% and 25%, respectively) and second-line patients (19% and 58%, respectively). Over 94% of these patients were treated in 2015 or later.
Conclusions
This is the largest observational study characterizing NSCLC patients with KRAS G12C mutations. One in five patients did not receive any systemic therapy, and of those treated, platinum-based therapies and PD-1/PD-L1i therapies were commonly used, consistent with treatment patterns expected in these patients. Survival and co-mutation data will be presented.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Amgen Inc.
Funding
Amgen Inc.
Disclosure
S. Aggarwal, S. Whipple, H. Tu, G. Carrigan, X. Wang, G. Ngarmchamnanrith, V. Chia: Shareholder/Stockholder/Stock options, Full/Part-time employment: Amgen. H. Hsu: Shareholder/Stockholder/Stock options, Full/Part-time employment: Amgen; Full/Part-time employment, Left in July 2019: Skye Biologics, Inc.