2022 World Conference on Lung Cancer (ePosters)-EP16.03-037. Poor Prognosis of Patients with EGFR Mutations Left behind by Selective Detection in NSCLC

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This study investigated the prognosis of patients with Epidermal Growth Factor Receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) who were not detected using selective detection methods. In a series of 254 NSCLC patients, EGFR mutations were detected using the cobas test, and the negative samples were subjected to direct sequencing (DS) to identify unselected mutations. It was found that some patients had EGFR mutations that were not detected by the selective testing methods.<br /><br />The patients with EGFR mutations that were left behind by selective detection were clinically identified as EGFR wild type and therefore missed the opportunity for treatment with EGFR tyrosine kinase inhibitors. These patients had a poor prognosis, as demonstrated by the overall survival analysis. The median overall survival for patients with EGFR mutations detected by cobas was 64.1 months, while for patients with EGFR mutations left behind by selective detection, the median overall survival was significantly lower at 6.9 months.<br /><br />Direct sequencing of the cobas negative samples revealed the presence of 8 EGFR mutations, including mutations in exons 18, 20, and 21. These mutations were not selected by the cobas test versions used in this study. Among the patients with recurrent disease after surgery, those with EGFR mutations that were not detected by cobas but were detected by DS had a significantly poorer prognosis compared to other patients.<br /><br />In conclusion, this study highlights the importance of detecting all EGFR mutations, including those missed by selective detection methods, to accurately identify patients who may benefit from EGFR tyrosine kinase inhibitor treatment. It suggests that patients with EGFR mutations left behind by selective detection have a poor prognosis and should be further investigated for appropriate treatment options.

Asset Subtitle

Taisuke Matsubara

Meta Tag

Speaker Taisuke Matsubara

Topic Tumour Biology and Biomarkers - Molecular Profiling and Targeted Therapies

Keywords

EGFR mutations

non-small cell lung cancer

prognosis

selective detection methods

cobas test

direct sequencing

unselected mutations

EGFR wild type

tyrosine kinase inhibitors

overall survival analysis