2022 World Conference on Lung Cancer (ePosters)-EP02.01-016. Molecular Alterations and Clinical Prognostic Factors in Resectable Non-Small Lung Cancer

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This study examined the prevalence of EGFR mutations (EGFRm) and PD-L1 expression in early stage non-small cell lung cancer (NSCLC) and evaluated their impact on recurrence-free survival (RFS). The study included 441 patients with resectable NSCLC, and the prevalence of EGFRm was found to be 57.8%. The most common EGFRm subtypes were Del19 (43%) and L858R (41%). PD-L1 positivity by SP263 antibody was observed in 20.5% of patients.<br /><br />The results showed that there was no difference in RFS based on EGFRm status. However, PD-L1-positive patients had significantly lower RFS compared to PD-L1-negative patients. Patients with both EGFRm and positive PD-L1 expression had the worst RFS compared to those with either double negative or EGFRm and negative PD-L1 status.<br /><br />Multivariable analysis identified higher levels of CEA (at a cut-off of 3.8 ng/ml), advanced pathological stage (pT4 and pN2), and positive margin as poor prognostic factors for RFS in the overall population, which was consistent with the findings in the EGFRm population.<br /><br />A predictive score for predicting recurrence was developed, with a score of 6 for the overall population and a score of 5 for the EGFRm population. These scores showed good sensitivity and specificity in predicting RFS.<br /><br />The study suggested that adjuvant EGFR-TKI therapy may provide more benefit in patients with EGFRm and positive PD-L1 expression. However, further validation of the predictive score should be performed in a larger cohort.<br /><br />In summary, this study found a high prevalence of EGFRm in resectable NSCLC, with Del19 and L858R being the most common subtypes. PD-L1 positivity was associated with poorer RFS. The results highlight the potential benefit of adjuvant EGFR-TKI therapy in patients with EGFRm and positive PD-L1 expression.

Asset Subtitle

Thanaporn Thamrongjirapat

Meta Tag

Speaker Thanaporn Thamrongjirapat

Topic Early Stage Non-small Cell Lung Cancer - Biomarkers

Keywords

EGFR mutations

PD-L1 expression

non-small cell lung cancer

resectable NSCLC

recurrence-free survival

Del19

L858R

SP263 antibody

predictive score

adjuvant EGFR-TKI therapy