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H. Chao



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    P3.02 - Biology/Pathology (ID 620)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P3.02-043 - Clinical and Genetic Features in Lung Adenocarcinoma Without EGFR Mutation and ALK Rearrangement in Taiwan (ID 9314)

      09:30 - 09:30  |  Author(s): H. Chao

      • Abstract
      • Slides

      Background:
      For the majority of advanced lung adenocarcinoma patients, absence of epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement usually means platinum based doublet chemotherapy would be the standard treatment. However, treatment result of chemotherapy is suboptimal. Several driver mutations, although not common, are potential therapeutic targets which may significantly influence patients’ outcome.

      Method:
      Lung adenocarcinoma patients with neither EGFR mutation nor ALK fusion were recruited in this study. KRAS, NRAS and BRAF mutations were examined by mass spectrometry. Other 53 gene fusions and mutations were analyzed by Archer FusionPlex Solid Tumor Kit on Ion Torrent PGM next generation sequencer.

      Result:
      Forty patients were enrolled. Demographics showed a median age of 62.5 (39-88), male predominance (M/F, 24/16), and non-smoking history dominance (never/past/current, 19/9/12). The average pack-year of smoking was 22.1 (0-120). The specimens examined were from lung (20), bone (1), brain (3), pleura (1), pleural effusion (11), lymph node (2) and soft tissue (2), respectively. Collectively, we identified eight KRAS mutations (20%), one NRAS mutation (2.5%), one BRAF mutation (2.5%), one CD74-ROS-1 fusion (2.5%), two MET exon 14 splicing (5%), and all of them were mutually exclusive. There were three invasive mucinous adenocarcinomas, and two of them harbored KRAS mutation. The majority of patients had received chemotherapy and two had received immunotherapy. The patient with CD74-ROS-1 fusion, a female non-smoker, was enrolled in an entrectinib clinical trial (STARTRK2) and experienced a rapid and dramatic response.

      Conclusion:
      Survey for other driver mutations brings treatment options for lung adenocarcinoma patients without EGFR mutation and ALK rearrangement.

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