2023 World Conference on Lung Cancer (Posters)-P2.09. A Large Asian Real-World EGFR exon 20Insertion Mutated NSCLC Dataset with Deep Genomic Characterization

P2.09. A Large Asian Real-World EGFR exon 20Insertion Mutated NSCLC Dataset with Deep Genomic Characterization - PDF(Abstract)

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This abstract discusses a study on the clinicopathologic and genomic characteristics of EGFR exon 20 insertion (ex20ins) mutated non-small cell lung cancer (NSCLC) in Asia. The researchers collected data from the National Cancer Centre Singapore database on NSCLC patients with ex20ins mutations. They also performed whole-exome sequencing on resected ex20ins tumors and combined the data with the TCGA database. <br /><br />The study found that the prevalence of EGFR ex20ins mutations in non-squamous NSCLC patients was 4.6%. The clinicopathologic features of 136 ex20ins mutated NSCLC patients were analyzed, and it was found that the majority of patients were Chinese, adenocarcinoma, and never smokers. The specific ex20ins variant was known in most patients, with the mutation located in the helical, near loop, or far loop regions of the EGFR protein.<br /><br />Treatment outcomes were evaluated in patients who received palliative systemic therapy, including platinum-doublet chemotherapy, EGFR TKI therapy, and immunotherapy. The responses to these therapies were limited, with median time to treatment failure on platinum-doublet chemotherapy being 4.9 months. The response rate to different generations of EGFR TKI therapy was higher in the helical region mutations compared to the near loop and far loop mutations. The response rate to anti-PD-1/L1 therapy alone was 16.7%.<br /><br />Genomic characterization of EGFR ex20ins mutated NSCLC showed comparable features to EGFR exon 19 deletion or L858R mutated NSCLC. There were no significant differences in tumor mutation burden, number of cancer driver co-mutations, or TP53 co-mutations between the two groups.<br /><br />In conclusion, EGFR exon 20 insertion mutations occur in a small percentage of Asian non-squamous NSCLC patients. The study highlights the limited efficacy of standard therapies in these patients and the high unmet need for targeted treatments. Further genomic analysis will be presented at the meeting.

Asset Subtitle

Aaron Tan

Meta Tag

Speaker Aaron Tan

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

EGFR exon 20 insertion

non-small cell lung cancer

NSCLC

Asia

clinicopathologic characteristics

genomic characteristics

ex20ins mutations

National Cancer Centre Singapore

whole-exome sequencing

TCGA database