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G.A. Oblitas



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    MO10 - Molecular Pathology II (ID 127)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Pathology
    • Presentations: 1
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      MO10.02 - Update genotyping non-small cell lung cancer (NSCLC) in Latin America: Latin-American Consortium for the Investigation of Lung Cancer (CLICaP) (ID 3462)

      16:20 - 16:25  |  Author(s): G.A. Oblitas

      • Abstract
      • Presentation
      • Slides

      Background
      Previously we reported that the frequency of mutations in EGFR and KRAS in non-small cell lung cancer (NSCLC) is Latinoamerica,finding the frequency of EGFR mutations in Latin-America between Asian (40%) and European (15%) populations. We report the update frequency of mutations in Latin America.

      Methods
      3606 biopsies of NSCLC patients from Latin-America (Argentina, Colombia, México and Peru) were used by extracted genomic DNA which was used to perform direct sequencing of EGFR gene (exons 18 and 21) and KRAS gene in 2385 samples.

      Results
      Of all patients the median age was 62.2 ±12.3, 52.6% were women, and 51% had smoking history. Frequency of EGFR mutations in NSCLC was 24.4% [CI 95% 22.7-24.1] (Argentina 14.4%, Colombia 24.9%, Mexico 34.4%, Peru 67.0%). The frequency of KRAS mutations was 7.1%. EGFR mutations were independently associated with gender (29.8% vs 16.3%; p< 0.001), older age (<60 vs >60; p= 0.001), non-smokers 25.9% vs 15.7%; p= 0.001), ethnicity (Hispanic 37.7%, Caucasic 13%, Afro-American 0%, non-determinate 22.9%; p< 0.001), histology (adenocarcinoma 23.8%, squamous 4.4%, large cells 33.3% and non differenced 22.2%) and absence of KRAS mutation. Overall response rate to tyrosine kinase inhibitors (EGFR-TKIs) in EGFR mutated patients (n=56) was 62.5% [95% CI 50-75] with a median overall survival of 16.5 months [95% CI 12.4-20.6].

      Conclusion
      Our findings confirm the high frequency of EGFR Mutation in Latino-america and low frequency of K-RAS mutation, particularly in patients of Hispanic ethnicity. Differences in risk factors associated with lung cancer in our population and ethnic variability could explain these findings.

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    P1.11 - Poster Session 1 - NSCLC Novel Therapies (ID 208)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.11-006 - Tyrosine kinase inhibitors versus chemotherapy in patients with metastatic Non-Small Cell Lung Cancer harboring EGFR mutation: Venezuelan experience (ID 699)

      09:30 - 09:30  |  Author(s): G.A. Oblitas

      • Abstract

      Background
      Lung cancer is the first cause of death globally. Platinum based chemotherapy is the standard of care for NSCLC. Maintenance therapy and switch therapy with novel agents have shown clinical benefit. The determination of the mutation of EGFR, allowed personalized therapy with tyrosine kinase inhibitors, providing benefit in terms of progression free survival and quality of life to those patient harboring the mutation.

      Methods
      An observational, analytic and descriptive study was conducted in Venezuela. 36 patients harboring the EGFR mutation were submitted to chemotherapy or tyrosine kinase inhibitors. The primary endpoint was the determination of the clinical benefit in terms of progression free survival according to the first line therapy.

      Results
      From a total of 296 patients with lung adenocarcinoma, the mutation rate was 12.2%. The EGFR mutation was found more frequently in patients with adenocarcinoma histology, males, less than 65 years old and those who were former smokers or nonsmokers. The most common type of mutation of the EGFR was found in the EXON 21, followed by EXON 19. 31 of these patients received first-line treatment with chemotherapy and 5 with tyrosine kinase inhibitors. The median progression-free survival for patients receiving tyrosine kinase inhibitors was 10 months and for those who received chemotherapy was 6 months. These findings were statistically significant (p = 0.03). Regarding the overall survival, no statistical significance was found, probably due to the crossing-over of the treatment.

      Conclusion
      The clinical benefit evidenced in Venezuelan patients harboring the EGFR mutation when treated with tyrosine kinase inhibitors in first and second line, was superior to the one shown by patients who received chemotherapy. These results are similar to those evidenced in clinical trials done worldwide. On this basis, we concluded that tyrosine kinase inhibitors should be used as first-line treatment in patients with EGFR mutation or during the course of their disease.