Author of

• 16831

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  P1.06 - Poster Session with Presenters Present (ID 458)

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

  • 16866

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    P1.06-035 - Frequency and Clinical Relevance of EGFR-Mutations and EML4-ALK-Translocations in Octagenarians with NSCLC (ID 5923)

    14:30 - 14:30  |  Author(s): D. Kauffmann-Guerrero
    • Abstract

    Background:
    Novel therapies targeting genetic alterations have improved response rates and overall survival for some patients with NSCLC; however, only a minority of caucasian patients with lung cancer benefit from these treatments. Testing for EGFR mutation and ALK translocation is recommended for all patients with advanced adenocarcinoma, but the highest occurance of these driver mutations has been described in younger patients, females, and those with little or no smoking history. The frequency of driver mutations in elderly and very elderly patients has not been described.
    
    Methods:
    We reviewed the charts of all patients over age 70 treated at our centre in 2015 and assessed the frequency of EGFR and ALK testing. We report the frequency of EGFR and ALK alterations in patients aged 70-74 , 75-79 and >80 years.
    
    Results:
    Out of 179 patients diagnosed at our centre in 2015, 15 were 80 years or older at the time of first diagnosis and 7 of 15 had non-squamous histology. Among these very elderly patients, 3 patients were found to have EML4-ALK translocations and 2 patients were found to have EGFR mutation (1 Del19, 1 L858R). This represents a 71% frequency of treatable driver mutations in octagenarians with non-squamous NSCLC. Rates of genetic drivers were somewhat lower, but still clinically relevant, in non-squamous NSCLC patients aged 70-74 (27.0%) and 75-79 (26.7%).
    
    Conclusion:
    Very elderly patients (>80 years of age) with non-squamous NSCLC were found to have high rates of the driver alterations EGFR mutation and ALK translocation. This is clinically relevant, as this often frail and comorbid population may not be suitable for treatment with cytotoxic chemotherapy and may benefit from first line treatment with a targeted tyrosine kinase inhibitor. Testing for these genetic alterations should not be restricted to younger patients. The biology of lung cancer in the very elderly may differ from that of moderately elderly patients, as the longevity of these patients may select for individuals more resistant to, or with little exposure to, environmental carcinogens.