2022 World Conference on Lung Cancer (ePosters)-EP08.02-084. Evaluation of Tumor Heterogeneity (TH) as a Prognostic Biomarker in Osimertinib treated Non-Small Cell Lung Cancer Patients

EP08.02-084. Evaluation of Tumor Heterogeneity (TH) as a Prognostic Biomarker in Osimertinib treated Non-Small Cell Lung Cancer Patients

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A study evaluated the tumor heterogeneity (TH) as a prognostic biomarker in non-small cell lung cancer (NSCLC) patients treated with Osimertinib. The aim was to predict the duration of therapeutic response based on the genomic diversity of the tumors. The study analyzed 135 EGFR driver alteration positive pre-treatment tissue tumor specimens from a real-world database. The cancer cell fraction (CCF) was estimated for each somatic short variant detected in the specimens. A TH score, calculated as the ratio of the median to the quartile coefficient of dispersion (QCD) of the CCF, was used to identify a high tumor heterogeneity group. The results showed that the TH low group had a significantly higher median progression-free survival (rwPFS) compared to the TH high group. Furthermore, subgroup analysis based on EGFR CCF and TH status showed that patients with high EGFR CCF and low TH had a longer rwPFS compared to patients with low EGFR CCF and high TH. These findings suggest that measuring the genomic heterogeneity of tumors from a single baseline biopsy may predict the duration of response to Osimertinib in NSCLC patients. However, further validation in external clinical cohorts is needed. The study also analyzed demographic and clinicopathologic characteristics of the cohort and the prevalence of select genomic features. The authors concluded that the TH score could effectively stratify responses to targeted therapy in a first-line setting and recommended further studies to understand its value as a prognostic biomarker in other disease indications beyond Osimertinib in NSCLC.

Asset Subtitle

Karthikeyan Murugesan

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Speaker Karthikeyan Murugesan

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

tumor heterogeneity

prognostic biomarker

non-small cell lung cancer

NSCLC

Osimertinib

genomic diversity

EGFR driver alteration

cancer cell fraction

progression-free survival

genomic heterogeneity