2023 World Conference on Lung Cancer (Posters)-P2.07. Genomic Subtypes of EGFR-Mutant NSCLC and Real-World Progression-Free Survival (rwPFS) with Immunotherapy (IO)

P2.07. Genomic Subtypes of EGFR-Mutant NSCLC and Real-World Progression-Free Survival (rwPFS) with Immunotherapy (IO) - PDF(Slides)

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This study aimed to investigate the impact of different subtypes of the epidermal growth factor receptor (EGFR) mutation in non-small cell lung cancer (NSCLC) on real-world progression-free survival (rwPFS) with immunotherapy (IO) using a large, nationwide database. The study categorized 8,368 NSCLC cases by EGFR subtype and compared them to EGFR wild-type (WT) using statistical tests. Among the 4,073 patients with advanced NSCLC treated with PD-1/PD-L1 inhibitors, rwPFS was determined for each EGFR subtype and compared to WT using Kaplan-Meier curves. <br /><br />The results showed that while most EGFR-mutant NSCLC tumors are resistant to PD-1/PD-L1 inhibitors, a small subset of patients with uncommon EGFR mutations, such as G719X or L861Q, can have durable responses. However, the study found that tumors with uncommon EGFR mutations did not have longer rwPFS with single-agent IO compared to WT. <br /><br />The study also found significant molecular heterogeneity among EGFR tumors, especially with respect to mutation subtypes. Exon 19del and L858R tumors had a lower percentage of cases with PD-L1 expression, while uncommon mutations had the highest percentage of cases with high tumor mutational burden. <br /><br />Furthermore, fewer patients with EGFR-mutant tumors had a history of smoking compared to WT. Among patients with EGFR-mutant tumors, those with uncommon mutations were more likely to have smoked. <br /><br />The study concluded that although tumors with uncommon EGFR mutations may have a more immunogenic profile, this did not translate into longer rwPFS with single-agent IO. More research is needed to overcome resistance to IO in EGFR-mutant NSCLC. This study was supported by grants from Fox Chase Cancer Center and the National Cancer Institute.

Asset Subtitle

Joseph Bodor

Meta Tag

Speaker Joseph Bodor

Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

epidermal growth factor receptor

EGFR mutation

non-small cell lung cancer

real-world progression-free survival

immunotherapy

PD-1/PD-L1 inhibitors

Kaplan-Meier curves

uncommon EGFR mutations

molecular heterogeneity

tumor mutational burden