Abstract B3: Relevance of genotyping non-small-cell lung cancer patients on response to platinum-basedchemotherapy and tyrosine kinase inhibitors

Abstract

Background: Subdividing non-small cell lung cancer (NSCLC) based on molecular alterations such as EGFR, KRAS and ALK genes is important for selecting treatment involving EGFR and EML4-ALK tyrosine kinase inhibitors (TKI). However, little information is available comparing patients' response and progression-free survival in the presence or absence of EGFR, KRAS mutations or the EML4-ALK fusion gene when being treated with chemotherapy. Methods: NSCLC patients were treated with chemotherapy and/or TKIs. Tests were performed for EGFR and KRAS gene mutation as well as EML4-ALK fusion genes. Progression-free survival and overall survival association with type of treatment and mutational status was analyzed. Results: The factors associated with a response to chemotherapy were the presence of EGFR and KRAS mutation (p = 0.006 and p = 0.028, respectively). Factors associated with TKI response were adenocarcinoma (HR 2.7: 1.6–4.6 95%CI; p<0.001), EGFR mutation (HR 0.5: 0.3–0.8 95%CI; p = 0.009) and wild-type KRAS (HR 1.7: 1.1–2.8 95%CI; p = 0.013). Mean progression-free survival in the chemotherapy group was 5.3 months (4.8–5.7 95%CI). Conclusion: EGFR and KRAS mutation status appeared to subdivide NSCLC patients into TKI and chemotherapy response groups.