2024 World Conference on Lung Cancer (WCLC) - Posters-P1.12B.08 Thrombotic Events at Diagnosis are Associated with Poorer First Line TKI Outcomes Among Metastatic ALK and ROS1 NSCLC Patients

P1.12B.08 Thrombotic Events at Diagnosis are Associated with Poorer First Line TKI Outcomes Among Metastatic ALK and ROS1 NSCLC Patients

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The study investigates the correlation between thromboembolic events at diagnosis and therapeutic outcomes in patients with metastatic ALK and ROS1 non-small cell lung cancer (NSCLC) undergoing first-line treatment with tyrosine kinase inhibitors (TKIs). Patients with oncogenic drivers, particularly those with ALK and ROS1 rearrangements, are prone to higher rates of arterial and venous thromboembolic events at diagnosis. The research reveals that thromboembolic incidents within 90 days of diagnosis are linked to poorer outcomes in these patients. Specifically, for ALK and ROS1 NSCLC patients experiencing these events at diagnosis, progression-free survival was significantly reduced (hazard ratio of 1.78), and overall survival was also adversely affected (hazard ratio of 2.84) compared to those without such events.<br /><br />Interestingly, in patients with EGFR-mutant NSCLC, peridiagnostic thromboembolic events did not correlate with negative outcomes in terms of progression-free or overall survival when treated with TKIs. These findings suggest the need for risk stratification based on thromboembolic predisposition, potentially driven by specific gene signatures or oncogenic profiles.<br /><br />The study employed a retrospective analysis method at a single center, spanning 137 patients between 2015 and 2023. It emphasized capturing venous or arterial thromboembolism as the primary event of interest within the early diagnostic phase, followed by regular imaging assessments.<br /><br />Future research directions include exploring thromboembolic risks associated with other driver oncogenes like RET, MET Ex14, and BRAF, alongside evaluating molecular signatures that may accentuate prothrombotic profiles in ALK and ROS1 phenotypes. This could enhance patient management by identifying those at an elevated risk of adverse outcomes. The study's acknowledgment of funding by the NIH underscores the importance and potential impact of these findings on clinical practices.

Asset Subtitle

Tejas Patil

Meta Tag

Speaker Tejas Patil

Topic Metastatic NSCLC – Targeted Therapy

Keywords

thromboembolic events

metastatic NSCLC

ALK rearrangements

ROS1 rearrangements

tyrosine kinase inhibitors

progression-free survival

overall survival

oncogenic drivers

retrospective analysis

gene signatures