Abstract 36P
Background
BRAF mutation is one of the targetable oncogenic driver mutations in non-small-cell lung cancer (NSCLC). However, the prevalence, real-world treatments and clinical outcomes are rarely reported in Chinese BRAF-mutated NSCLC patients.
Methods
The next-generation sequencing (NGS) data of 137,798 Chinese NSCLC patients from the Lung Cancer Big Data Precise Treatment Collaboration Group (LANDSCAPE) project (Cohort I) were analyzed to derive the prevalence of BRAF mutations. We also retrospectively collected clinical and survival data of 129 advanced NSCLC patients with primary BRAF mutation from two centers between December 2015 and September 2022 (Cohort II). Baseline characteristics, treatment pattern and outcomes were analyzed in Cohort II.
Results
In Cohort I, 4409 patients (3.2%) were confirmed to harbor a BRAF mutation. BRAF V600E accounted for 28.7% of all BRAF mutation. In Cohort II, 62% (80/129) were BRAF V600 mutation with median age of 63.0 years. Of 99 patients who receive NGS, 79 (79.8%) patients had concomitant mutations, with TP53 of the highest incidence (33.3%). For patients received first-line dabrafenib plus trametinib (dab-tram) (N = 38), the median progression-free survival (PFS) was 25.0 months (95%CI: 13-NA), which is significantly longer than chemotherapy (N = 38, mPFS 8.4 months, 95%CI: 6.3–19.2, P = 0.023) and other regimens (N = 11, mPFS 8.0 months, 95%CI: 7.8-NA, P = 0.046). A numerically longer mPFS was also observed with dab-tram versus immunotherapy based therapy (N = 22, mPFS 11.4 months, 95%CI: 7.8-NA, P = 0.25). After applying inverse probability of treatment weighting (IPTW), the above differences still existed.
Conclusions
In the study with the largest sample size so for, 3.2% of Chinese NSCLC patients were observed to have BRAF mutations. The more favorable PFS benefit demonstrated by first-line dabrafenib plus trametinib compared with all other therapy regimens indicates the optimal treatment choice for Chinese BRAF-mutated NSCLC patients.
Legal entity responsible for the study
Peking University Cancer Hospital.
Funding
Science Foundation of Peking University Cancer Hospital.
Disclosure
All authors have declared no conflicts of interest.