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S.W. Chan
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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-055 - Survival in Non-Small Cell Lung Cancer (NSCLC) Patients (pts) with Driver Mutations at Sandton Oncology Centre, South Africa (ID 5253)
14:30 - 14:30 | Author(s): S.W. Chan
- Abstract
Background:
The administration of tyrosine kinase inhibitors (TKI) has changed the treatment of NSCLC pts with driver mutations. In the Lung Cancer Mutation Consortium study, survival was significantly better for those with an oncogenic driver which received a TKI compared to those who did not.
Methods:
Retrospective records review was performed on NSCLC pts treated at Sandton Oncology Centre (SOC), between 1/1/2010 and 31/12/2015.
Results:
There were 176 lung cancer pts in total, of which 25 were small cell and 151 NSCLC. 129 pts (85%) had non-squamous histology. 85 pts (all non-squamous) had EGFR and/or ALK mutations tested. Driver mutations (n=25) were detected in adenocarcinoma pts, with 22 EGFR mutations (EGFR mutation rate = 26%), 2 ALK re-arrangements, and 1 ROS1 mutation. Among 20 known EGFR mutations, 13 were Exon 19 deletions, 6 were L858R mutation, and 1 had dual G719X & S768I mutations. Median age for pts with driver mutations was 62.5 years (39-77). There were 16 females and 8 males (17 Caucasians, 5 Africans, 1 Chinese, and 1 Indian). Both ALK and ROS1 mutations were detected in adenocarcinoma, in Caucasians and in never smokers. 82 of the 85 pts tested for mutations had documented smoking status. Driver mutation rates were higher in never (17/25, 68%) and former smokers (6/32, 19%), than current smokers (2/25, 8%). 21 pts with driver mutations were evaluable for survival. 19 pts received TKI at least once in their lifetime (TKI ever), and 2 pts never received TKI (TKI never). First-line TKI was given in 11 pts and was associated with higher response rate (50%) than platinum-based chemotherapy (38%). Median PFS was not different between first-line treatment received (274 days in platinum-based chemotherapy, versus 291 days with TKI, p=0.58). Median OS was significantly longer in TKI ever group compared to TKI never group (809 days and 81 days, respectively, p=0.0235). OS was not influenced by smoking status, sex, race, first-line treatment received or specific EGFR mutations.
Conclusion:
Based on our retrospective analysis, we recommend that driver mutations be tested in all pts with non-squamous histology. NSCLC pts with driver mutations should receive a TKI at some point in the course of their treatment. Although we could not demonstrate improvement in PFS associated with first-line TKI therapy, the overall survival documented at our centre for the TKI ever group was consistent with international published data.
