Abstract 436P
Background
Lung cancer (LC) is the third most common cancer in Malaysia with a 5-year survival rate of 11%. To date, there is limited comprehensive integration of demographic, clinical, and treatment data within the Malaysian population due to limited resources. This pilot study aims to examine these parameters in a single-center tertiary care private hospital in Malaysia.
Methods
A retrospective study was conducted on 330 LC patients aged between 56 and 75 years old at Sunway Medical Centre from 2019 to 2023. Data on demographics, clinical characteristics, genomic profiles and treatments were analyzed.
Results
In the cohort, 306 (93%) were diagnosed with non-small cell lung cancer (NSCLC), predominantly adenocarcinoma (76%), with the majority (78%) being Chinese patients. Genomic testing identified actionable mutations in several genes in 198 (65%) NSCLC patients, including EGFR, TP53, ALK, KRAS, PIK3CA, HER2, ROS1, CTNNB1, RET and MET genes. Our cohort exhibited a prevalence of EGFR mutation at 57%, significantly higher than the 10%–20% observed in Western populations, underscoring the importance of EGFR-targeted therapies in our population. Among the 306 NSCLC patients, 222 underwent PD-L1 testing, with PD-L1 expression detected in 142 (64%). The distribution of PD-L1 positivity between EGFR-mutant and wild-type patients was similar, with each group comprising 50% of the PD-L1-positive cases. Out of the 57 treated patients who were EGFR- and PD-L1-positive, EGFR-targeted therapies was the standard of care for the majority (88%). Advanced-stage NSCLC was observed in 232 (76%) patients, exhibiting a significantly longer treatment delay of 17 days, in contrast to 9 days for early-stage cases (p < 0.05). Immunotherapy use increased from 15% in 2019 to 35% in 2023, primarily for advanced cases.
Conclusions
This pilot study provides important and interesting preliminary insights into the clinical, genomic and treatment landscape of LC in a tertiary care private institution in Malaysia. Further studies are urgently warranted in order to examine the molecular pathogenesis and treatment of LC in our population and to address the challenges arising from the overall LC management in Malaysia in accordance with international guidelines.
Legal entity responsible for the study
Sunway Medical Centre.
Funding
Sunway Medical Cnetre.
Disclosure
All authors have declared no conflicts of interest.