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J.H. Ficker
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P2.03a - Poster Session with Presenters Present (ID 464)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03a-060 - Favorable Survival of TTF-1 Expression in Pemetrexed Based Treated NSCLC Patients (ID 5368)
14:30 - 14:30 | Author(s): J.H. Ficker
- Abstract
Background:
The translational research analysis of the Pointbreak study could demonstrate superior overall survival (OS) for TTF-1 expressing NSCLC in comparison to TTF1-1 negatives treated with Pemetrexed based chemotherapy. The aim of this study was to prove retrospectively whether this finding can be reproduced in patients from the daily clinical practice in three different german hospitals.
Methods:
323 patients (pts), 182m, 141f, median age 64 years (34-84) with non-sqamous NSCLC stage UICC IIIB/IV undergoing pemetrexed based palliative chemotherapy were analyzed for TTF- 1 expression by immunohistochemistry and outcome.
Results:
246 pts (76%) were TTF-1 positive, well balanced for for age and gender. Median number of administered chemotherapy cycles was 4 in both groups; 19 pts (5.9%) received maintenance therapy. Response was superior in TTF-1 expressing (vs non-expressing) patients (CR 2% vs. 6%, PR 58% vs. 39%, NC 21% vs. 16%, PD 19% vs. 39%, X[2]=14.4, p<0.002) as well as OS (MST 14.5m vs. 8.3m, HR=0.44, CI 0.33-0.58, p<0.0001) and progression free survival (PFS: MST 7.7m vs. 4.8m, HR 0.51, CI 0.35-0.74, p<0.001). 1-y and 2-y OS were 59% and 23% for TTF-1 expressing pts compared to 34% and 0%, respectively In multivariate analysis TTF-1 expression (HR= 0.43, CI 0.30 - 0.63, p<0.0001) and 4 vs. 6 cycles of chemotherapy (HR=0.81, CI 0.70 - 0.95, p=0.009) were the only independent factors for OS. For PFS TTF-1 expression was the only independent predictive factor (HR=0.49, CI 0.31-0.77, p=0.002).
Conclusion:
These results confirm the relevance of TTF-1 expression on outcome in pemetrexed based chemotherapy with TTF-1 being of significant independent prognostic relevance. Further analyses with TTF-1 in non pemetrexed treated patients are ongoing to evaluate its predictive value.
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-036 - Analysis of Potentially Targetable Mutations in 821 Patients with Squamouscell Lung Cancer Undergoing Routine NGS-Based Molecular Diagnostics (ID 5939)
14:30 - 14:30 | Author(s): J.H. Ficker
- Abstract
Background:
Molecular multiplex diagnostics is increasingly integrated now in routine diagnostics of lung adenocarcinoma (LAD). Although targetable aberrations are predominantly found in LAD, they have also been reported in squamouscell lung carcinoma (SQLC). We here present results of routine molecular multiplex diagnostics of advanced stage SQLC obtained within the German Network Genomic Medicine (NGM) and compare them with results reported previously in early stage SQLC in The Cancer Genome Atlas (TCGA) LUSC cohort.
Methods:
Tumor biopsies of 821 patients consecutively diagnosed within NGM were analyzed with next-generation parallel sequencing (NGS). The panel consisted of 102 amplicons and 14 genes: KRAS, PIK3CA, BRAF, EGFR, ERBB2, NRAS, DDR2, TP53, ALK, CTNNB1, MET, AKT1, PTEN and MAP2K1. In subsets of patients, fluorescence in-situ hybridization (FISH) was performed for amplification detection of FGFR1 and MET. We queried the TCGA dataset with respect to the panel used and compared the findings. For NGM patients, therapy and outcome are also reported..
Results:
In addition to the expected frequencies of TP53, DDR2, PTEN and PIK3CA mutations, we detected EGFR mutations in 3.2% and BRAF mutations in 1.8%. Unlike the TCGA dataset, where the frequencies were 2.8% and 3.9%, respectively, the detected mutations in the NGM cohort included also activating targetable mutations (i. e., EGFR del19 and L858R, and BRAF V600E). FISH data revealed presence of MET amplification in 14.2% and of FGFR1 amplification in 20.0%. The association and correlation of these aberrations with clinical findings and prognosis as well as with PD-L1 expression status and mutational load will be presented.
Conclusion:
Our data give an overview on the presence and clinical characteristics of targetable mutations in advanced SQLC and show, that such mutations occur in a substantial amount of patients. Thus, molecular multiplex diagnostics might be indicated also in SQLC in order to use all therapeutic options available in these patients.
