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S.P. Gangadharan
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P3.03 - Chemotherapy/Targeted Therapy (ID 719)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.03-025 - Tumor Biomarkers for the Routine Care of Advanced Non-Small-Cell Lung Cancer: A Decade of Experience in Implementing Predictive Genomic Events (ID 10193)
09:30 - 09:30 | Author(s): S.P. Gangadharan
- Abstract
Background:
Although a growing list of mandatory genomic/immune-based biomarkers are now routinely integrated into the management of advanced non-small-cell lung cancer (NSCLC), few reports have detailed the evolution of NSCLC predictive biomarker assessment in routine clinical practice.
Method:
We retrospectively probed 1,000+ NSCLC-patient pairs analyzed for predictive biomarkers from 2004 to 2017 at our institution and evaluated patterns of testing as well as correlation with clinical-pathologic characteristics.
Result:
The majority of 1,009 patient-tumor pairs had advanced adenocarcinoma with most specimens obtained from lung, mediastinal/hilar nodes, and pleura and with a similar distribution between surgical, small biopsy, and cytology specimens. All were tested for EGFR mutations, 895 for ALK rearrangement, 841 for KRAS mutation, 537 for ROS1 rearrangement, and 179 using comprehensive genomic profiling. Implementation of near-universal genomic biomarker testing for EGFR, ALK, ROS1 and PD-L1 occurred within the first year following evidence of activity/approval of a paired therapy. The failure rate after use of the best specimen for the most common tests was ≤5.5%. A quarter of tumors had a driver oncogene (EGFR/ALK/ROS1/BRAF-V600E) with an approved oral therapy, with the highest prevalence in patients with ≤15 pack-years tobacco use.
Conclusion:
Tumor biomarker testing in routine clinical NSCLC specimens at our institution evolves rapidly following approval of new therapies linked to diagnostic assays. Our practice’s decade-plus experience indicates that it will be feasible for the thoracic oncology community to continue to expand the use of predictive genomic and immune biomarkers using currently available clinical specimens.
