2023 World Conference on Lung Cancer (Posters)-EP12.03. Prognostic Value of TP53 Commutations Among Hispanic Patients with Advanced EGFR-positive NSCLC Treated with First Line Osimertinib.

EP12.03. Prognostic Value of TP53 Commutations Among Hispanic Patients with Advanced EGFR-positive NSCLC Treated with First Line Osimertinib. - PDF(Slides)

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A study was conducted to evaluate the prognostic value of TP53 mutations in Hispanic patients with advanced EGFR-positive non-small cell lung cancer (NSCLC) who were treated with first-line osimertinib. TP53 is a frequently mutated gene in NSCLC and has been associated with resistance to EGFR-targeted therapy and poor prognosis. <br /><br />The study included 72 patients with advanced-stage EGFR-mutant NSCLC who were treated with osimertinib. It was found that 32% of the patients had TP53 mutations. The patients with TP53 mutations had a mean age of 58 years, 61% were women, and 96% had adenocarcinomas. In terms of smoking history, 61% were never smokers and 35% were ex-smokers. <br /><br />Among the patients with EGFR/TP53 mutations, 65% had the L858R mutation and 52% had more than three genomic alterations. The mean tumor mutational burden (TMB) was 6.0. In comparison, among the patients without TP53 mutations, 71% had the del19 mutation and only 2% had more than three mutations. The mean TMB was 1.2. It was found that none of the patients without TP53 mutations had a PD-L1 expression greater than 50%. <br /><br />The study also analyzed the response and survival outcomes. The overall response rate in patients with EGFR/TP53 mutations was 22.0%, while it was 67.3% in patients without TP53 mutations. The progression-free survival (PFS) for osimertinib in the EGFR/TP53 mutation group was 10.9 months, compared to 26.6 months in the non-TP53 mutation group. The overall survival (OS) was 20.7 months in the EGFR/TP53 mutation group and 39.0 months in the non-TP53 mutation group. TP53 mutations and high TMB were found to be factors that significantly impacted OS. The presence of brain metastases also had a trend towards affecting OS. <br /><br />In conclusion, the presence of TP53 mutations in Hispanic patients with EGFR-mutant NSCLC negatively impacted the response, PFS, and OS to osimertinib. The biology of EGFR/TP53 tumors appears to be more aggressive, particularly in the presence of the L858R variant. Further studies are needed to better characterize this population and explore additional therapies for patients with EGFR/TP53 mutations and high TMB.

Asset Subtitle

Leonardo Rojas

Meta Tag

Speaker Leonardo Rojas

Topic Metastatic NSCLC: Targeted Therapy - Other

Keywords

TP53 mutations

Hispanic patients

EGFR-positive non-small cell lung cancer

NSCLC

osimertinib

EGFR-targeted therapy

prognosis

tumor mutational burden

response rate

progression-free survival