2024 World Conference on Lung Cancer (WCLC) - Posters-P2.11A.17 Impact of Mutation Class and Smoking Status in BRAF-Mutant Non-Small Cell Lung Cancer (NSCLC) Treated with Immune Checkpoint Inhibitors (ICI)

P2.11A.17 Impact of Mutation Class and Smoking Status in BRAF-Mutant Non-Small Cell Lung Cancer (NSCLC) Treated with Immune Checkpoint Inhibitors (ICI)

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This retrospective analysis at Moffitt Cancer Center examined the outcomes of individuals with BRAF-mutant non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI), considering mutation class (I or non-class I) and smoking status. The study analyzed patients from January 2012 to August 2023 using data from electronic medical records. <br /><br />Key findings indicated that the presence of BRAF mutations, often linked to smoking, drastically affects treatment outcomes with ICI, chemotherapy, and chemo-ICI combinations. Notably, the analysis showed that patients with class I mutations and higher PD-L1 expression (≥1% and ≥50%) experienced better progression-free survival (PFS) and overall survival (OS) with ICI or chemo-ICI treatments. <br /><br />Specifically, smokers with non-class I mutations showed almost significantly better PFS compared to never-smokers. Additionally, OS was improved in class I mutation carriers and in smokers versus never-smokers with non-class I. Despite this, treatment benefits were particularly pronounced for patients without central nervous system metastases, where ICI or chemo-ICI resulted in significantly better outcomes compared to chemotherapy alone.<br /><br />The study highlighted a notable trend towards improved OS for smokers versus never-smokers with non-class I mutations, but only among never-smokers for class I mutations. These outcomes underline the importance of mutation class and smoking status in tailoring systemic therapy for BRAF-mutant NSCLC and suggest that patients with class I mutations and smokers, who typically bear a heavier mutation burden, may derive more considerable benefit from ICIs. The findings also encourage further exploration into the benefits of frontline ICI/chemo-ICI strategies, particularly in those presenting high PD-L1 expression and absence of CNS metastasis.

Asset Subtitle

Julian Marin-Acevedo

Meta Tag

Speaker Julian Marin-Acevedo

Topic Metastatic NSCLC – Immunotherapy

Keywords

BRAF-mutant

non-small cell lung cancer

immune checkpoint inhibitors

mutation class

smoking status

progression-free survival

overall survival

PD-L1 expression

central nervous system metastases

systemic therapy