2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12B.15 ALK-Fusion Positive NSCLCs: Diversity in Mutations and Co-Mutations with Therapeutic Perspective and Clinical Outcomes

EP.12B.15 ALK-Fusion Positive NSCLCs: Diversity in Mutations and Co-Mutations with Therapeutic Perspective and Clinical Outcomes

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This retrospective study from a community oncology practice in India explores the clinical and molecular characteristics of ALK-fusion-positive non-small cell lung cancers (NSCLCs), focusing on mutation diversity, co-mutations, treatment modalities, and clinical outcomes. The study analyzed data from 50 patients with ALK mutations treated between March 2018 and December 2023. Key findings include:<br /><br />1. **Demographics and Clinical Features:** Patients had a median age of 56.5 years, with a male-to-female ratio of 1:1.08. Most patients were diagnosed with stage IV adenocarcinoma (92% and 96% respectively), and 15 out of 50 had baseline brain metastasis. <br /><br />2. **Mutation and Co-Mutation Landscape:** ALK mutations were present in 4.7% of NSCLC cases. EGFR co-mutations were the most common, occurring in 9 out of 14 patients that had co-mutations. Other co-mutations included TP53, ROS, PIK3CA, and BRAF.<br /><br />3. **Treatment Strategies:** The majority (74%) of patients received Tyrosine Kinase Inhibitors (TKIs) as the first line of treatment. The usage distribution among TKI generations was 34% for first-generation, 38% for second-generation, and 2% for third-generation. A smaller percentage, 16% of patients, received chemotherapy initially. <br /><br />4. **Survival Outcomes:** The median survival for the cohort was 35 months, with follow-up time averaging 36 months. This underlines a significant point about the impact of ALK-directed therapies, which have altered the treatment paradigms in NSCLC cases.<br /><br />The study highlights the importance of understanding mutation diversity and co-mutations in tailoring therapy, as these factors significantly influence treatment decisions and survival outcomes. The findings underscore the effectiveness and accessibility of first-generation TKIs and the beneficial impact of patient assistance programs in improving treatment adherence and outcomes. This study provides valuable insights into the treatment landscape for ALK-fusion-positive NSCLC in a real-world setting, particularly in Western India.

Asset Subtitle

Kshitij Joshi

Meta Tag

Speaker Kshitij Joshi

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

ALK-fusion-positive

non-small cell lung cancer

NSCLC

mutation diversity

co-mutations

treatment modalities

clinical outcomes

Tyrosine Kinase Inhibitors

survival outcomes

Western India