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J. Timar
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-003 - Metastatic Site-Specific Variation of KRAS Status in Lung Adenocarcinoma (ID 2704)
09:30 - 09:30 | Author(s): J. Timar
- Abstract
Background:
While KRAS mutation is a negative predictive marker for EGFR tyrosine kinase inhibitor therapy, there is limited data available regarding the influence of KRAS mutation on the organ specificity of lung adenocarcinoma metastases.
Methods:
In our retrospective, single center study, 820 lung adenocarcinoma patients with KRAS mutation analyses were included. At the time of diagnosis, 462 patients had metastatic disease. These cases were analyzed for the potential association between KRAS status and metastatic site and clinical outcome. Patients with known EGFR mutations were excluded from the study.
Results:
534 (65.3%) KRAS wild-type and 284 (34.7%) KRAS-mutant cases were identified. There was no difference in the KRAS mutation prevalence between the metastatic (35.7%) and non-metastatic cases (33.4%). The most frequent metastatic sites included bone (29%), contralateral lung (24.8%), ipsilateral lung (19.7%), brain (17.3%), adrenal gland (15.6%), pleura (12.8%) and liver (11.7%). Patients with multiple metastases tended to have inferior median overall survival (OS) compared to those with single-organ metastasis (6.3 vs. 8.2 months, respectively; p=0.09) and, moreover, showed a slight but non-significant increase in the prevalence of KRAS mutations (38.5%, p=0.35). Importantly, patients with brain (35.8%), bone (33.1%) or adrenal gland (35.2%) metastases demonstrated similar KRAS mutation frequencies. However, both ipsilateral and contralateral intrapulmonary metastatic cases demonstrated increased KRAS mutation frequency when compared to those with extrapulmonary metastases (42.2% and 42.5%, p=0.014). In contrast, pleural dissemination and liver metastasis were associated with decreased KRAS mutation prevalence (25.4% and 24.1%, respectively; p=0.007). We found no difference in the median OS between KRAS-mutant and WT cases in any metastatic site-specific analysis.
Conclusion:
Lung adenocarcinoma patients with KRAS-mutant tumors more often present with intrapulmonary metastases. KRAS mutation prevalence, however, lacks to provide prognostic information. Further studies are required to determine if KRAS status can be used to risk stratify patients for the onset of pulmonary metastasis.
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-045 - Insights into NSCLC Molecular Testing in Central and Eastern European Countries (ID 2615)
09:30 - 09:30 | Author(s): J. Timar
- Abstract
Background:
Information is lacking about molecular testing practices for NSCLC in Central and Eastern Europe; identification of the challenges for personalized lung cancer treatment within this region might facilitate strategies to overcome these and to improve patient care.
Methods:
A Working Group of oncologists, pulmonologists and pathologists from Central and Eastern Europe was established in order to get more information about NSCLC molecular testing used in these countries, technologies, patient selection, availability and other questions, and to raise greater awareness of the current issues around personalized medicine for lung cancer in this region. As a first step, a questionnaire including 37 questions about issues connected with NSCLC molecular testing and other aspects of NSCLC management was distributed in 2014 to 59 specialists in different areas of NSCLC, including epidemiologists, oncologists, pulmonologists and pathologists.
Results:
In all, 25 experts from 9 countries (Bulgaria, Croatia, Czech Republic, Hungary, Israel, Poland, Slovakia, Slovenia, Turkey) responded. The responses show that there are some differences between the countries in the region and also between centers within countries with regard to NSCLC molecular testing. Some are minor, e.g. for EGFR mutation testing real-time PCR is used in all countries, direct sequencing in 5, and other methods are used in addition in only 2 countries. Up to one-quarter of samples are inadequate for testing. For ALK testing, IHC followed by FISH and/or FISH alone are currently used in all 7 countries with responses; in Israel, other methods including DNA sequencing are also used. However, some of the differences are quite large, such as the proportion of eligible patients tested for EGFR mutations and ALK rearrangements, and the proportion of NSCLC patients discussed at multidisciplinary tumor boards. There is also wide variation in funding sources for EGFR and ALK testing.
Conclusion:
NSCLC molecular testing is available in all Central and Eastern European countries participating in this survey. For the future, ensuring adequate NSCLC samples, solving sustainable financing of molecular testing and enabling wide access of eligible patients to molecular testing resulting in raising the number of patients reviewed by multidisciplinary boards are among the key challenges.
