Author of

• 16549

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  P1.02 - Poster Session with Presenters Present (ID 454)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Biology/Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16556

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    P1.02-007 - Alk Translocated NSCLC in the West of Scotland: Patient Demographics and Outcomes (ID 4199)

    14:30 - 14:30  |  Author(s): P. Westwood
    • Abstract

    Background:
    A translocation in the anaplastic lymphoma kinase gene is found in 3-5% of non-small cell lung cancer (NSCLC). Patients with this mutation (ALK+) have shown marked responses to the tyrosine kinase inhibitor crizotinib. Second line Crizotinib has been available in Scotland since October 2013 for patients with ALK+ NSCLC. Since January 2014, reflex testing at diagnosis of all non-squamous NSCLC has been carried out in the West of Scotland (WoS) regardless of stage. Here we present the demographics of an Alk +ve cohort from an unselected Scottish NSCLC population and their clinical outcomes.
    
    Methods:
    Details of patients with Alk+ NSCLC were obtained from the regional molecular genetics laboratory. 60 patients with NSCLC from WoS tested ALK+ between 1st January 2014 and 30[th] June 2016. Patient records were reviewed retrospectively.
    
    Results:
    Median laboratory turnaround for alk testing was 21 days in 2014, 14 days in 2015 and 13 days in 2016. 3 (5%) patients were under 50 years, 8 (13%) 50-60 years, 23 (38%) 60-70 years, 17 (28%) 70-80 years and 9 (15%) patients were > 80 years old at time of testing. Median age was 69. 55% were male and 45% female. 67% were current or ex smokers. Only 22% were never-smokers. The majority (82%) had stage 3 or 4 disease at diagnosis. Only 39% (17/38) of patients with stage 4 ALK+ NSCLC were well enough to receive chemotherapy and 4 of these (24%) did not complete all planned cycles. 10 patients have received crizotinib so far. Median number of cycles is 3 overall (range 1-9). Where documented, reasons for discontinuation were disease progression or death from NSCLC (4), sudden death not related to NSCLC (2), intercurrent illness (2) and pneumonitis (1) . 3 patients continue on crizotinib as of June 2016. Of the 13 patients who have received crizotinib, 3 have had a PR, 4 SD 2 PD and 4 NE. Updated outcomes will be presented.
    
    Conclusion:
    A high quality reflex ALK testing service is being delivered in WoS with clinically acceptable turnaround times. Our ALK+ patients do not entirely reflect the literature and are frequently elderly, current or ex-smokers with advanced and aggressive disease. This may reflect the unselected nature of this population. Many Alk+ patients were too unwell to receive chemotherapy or tolerated it poorly and did not have the opportunity to access an alk inhibitor. First line Alk inhibitors may improve outcomes for this group of patients.