2023 World Conference on Lung Cancer (Posters)-P2.12. Response to Emerging Targeted Therapies and Genomic Analysis for NSCLC with Leptomeningeal Metastases and Uncommon Mutations

P2.12. Response to Emerging Targeted Therapies and Genomic Analysis for NSCLC with Leptomeningeal Metastases and Uncommon Mutations - PDF(Abstract)

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This presentation discusses the response to emerging targeted therapies and genomic analysis for non-small cell lung cancer (NSCLC) patients with leptomeningeal metastases (LM) and uncommon mutations. The study focuses on patients with atypical EGFR mutations, ROS1/RET fusions, and ERBB2 alterations. Among 7548 patients with advanced NSCLC, 82 patients had LM and harbored these uncommon genetic drivers. <br /><br />The study found that 42.7% of patients had a performance status of 2, and 75.6% received at least one line of systemic treatment. After LM diagnosis, 64.6% of patients were treated with targeted therapy. The three-month progression-free survival rates were 36.8%, 77.8%, and 23.1% in the three different genetic groups. The overall response rates were 22%, 50%, and 11.1%, respectively. Median overall survival was longest in patients with fusions compared to those with atypical EGFR or ERBB2 mutations. Patients with ROS1 fusion had longer overall survival than those with RET fusion. <br /><br />The study also analyzed 257 cerebrospinal fluid samples with molecular profiles. Co-mutations were detected in 5% of the atypical EGFR group and included genes like TP53, MYC, CDK4, and CDKN2A, similar to the classical EGFR mutation group. <br /><br />In conclusion, patients with LM and atypical EGFR mutations and ROS1/RET fusions have improved prognoses with targeted therapies, while those with ERBB2-positive LM showed poor survival outcomes. Atypical EGFR mutations and classical EGFR mutations have similar co-mutation profiles, while ROS1/RET fusion has its unique genomic profiling.<br /><br />Keywords: NSCLC, Leptomeningeal Metastases, Uncommon Mutation.

Asset Subtitle

Guang-Ling Jie

Meta Tag

Speaker Guang-Ling Jie

Topic Metastatic NSCLC: Targeted Therapy - Other

Keywords

NSCLC

Leptomeningeal Metastases

Uncommon Mutation

Targeted Therapies

Genomic Analysis

Atypical EGFR Mutations

ROS1/RET Fusions

ERBB2 Alterations

Performance Status

Systemic Treatment