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C.H. Leong
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P3.01 - Advanced NSCLC (ID 621)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.01-020 - Clinical Features of Patients with Non-Small Cell Lung Cancer (NSCLC) Harbouring Epidermal Growth Factor Receptor (EGFR) Mutations in Brunei (ID 8891)
09:30 - 09:30 | Author(s): C.H. Leong
- Abstract
Background:
Brunei is indifferent to its neighbouring South East Asia countries whereby the highest cancer mortality rate is attributed to lung cancer. EGFR mutations are present in a subset of patients with non-squamous NSCLC that predict a favourable response to EGFR tyrosine kinase inhibitor (TKI) therapy. Thus far, the prevalence of EGFR mutations in Brunei patients with NSCLC remains unknown. This study was conducted to characterise non-squamous NSCLC patients with EGFR mutations in Brunei.
Method:
Retrospective data collection from clinical case notes of patients with non-squamous NSCLC diagnosed from January 2010 to March 2017 was undertaken at The Brunei Cancer Centre to determine the frequency of EGFR mutations and correlation with clinico-pathological variables. The progression-free survival (PFS) of EGFR mutated patients on EGFR TKI and the overall survival (OS) of patients with mutated and wild type EGFR were estimated and compared using Kaplan-Meier curves and log-rank tests.
Result:
EGFR mutation status was evaluable in 71 out of 191 lung adenocarcinoma cases. The overall mutation frequency was 43.7 % with a mean age of 63.3 years. EGFR mutations were significantly more common in female (71%) and never smokers but 33.3% of patients with EGFR mutations were current smokers. The most prevalent EGFR mutation was exon 21 point mutation (L858R) (43.3%) followed by exon 19 deletion (40.0%). 87% of patients with EGFR mutations received EGFR TKI therapy and the objective response rate (ORR) was 65.2%. The median PFS for patients on EGFR TKI was 7 months and there was no significant differences between the two most common mutations. The median PFS of patients treated with EGFR TKI upfront and after first line chemotherapy was 8 and 6 months (p=0.045) respectively. Although not statistically significant (p=0.232), our result showed a trend of improvement in median OS for EGFR mutated patients (29 months) compared to wild type (17 months).
Conclusion:
This is the first study to reveal the clinical characteristics of patients with EGFR mutated non-squamous NSCLC in Brunei. The prevalence of EGFR mutation in our study is high and comparable to other Asian NSCLC patients. Interestingly, PFS rate on EGFR TKI observed in our population was inferior to published studies despite the high ORR and this warrants further exploration. Nevertheless, EGFR mutation analysis should be performed in all patients with non-squamous NSCLC to identify the subset of patients who may benefit from EGFR TKI.
