WCLC 2025 - Posters & ePosters-EP.06.21 Genomic and Demographic Predictors of Survival in Patients With ALK Fusion NSCLC: Insights From a Single-Center Cohort

EP.06.21 Genomic and Demographic Predictors of Survival in Patients With ALK Fusion NSCLC: Insights From a Single-Center Cohort

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This study reviewed consecutive electronic medical records of patients with anaplastic lymphoma kinase (ALK) fusion non-small cell lung cancer (NSCLC) treated at Cedars-Sinai Cancer Center from 2019 to 2023 to identify demographic and genomic predictors of survival. Statistical comparisons of patient characteristics employed two-sample T-tests, Chi-squared, or Fisher’s exact tests, while overall survival (OS) was analyzed using Kaplan–Meier curves and log-rank tests.<br /><br />Patients with ALK fusion NSCLC typically experience prolonged survival, as demonstrated in previous phase III trials of ALK-targeted tyrosine kinase inhibitors (TKIs), where median OS has often not been reached. However, survival outcomes in this cohort were heterogeneous. Among 68 patients (53 alive, 15 deceased), those who died had significantly shorter median OS (43 months versus not reached, p=0.001). Age, sex, ethnicity, race, and smoking status were not significantly associated with survival differences.<br /><br />Genomic analyses identified alterations in TP53 and MTAP genes as predictors of poor prognosis. TP53 mutations were more prevalent in deceased patients (53% vs. 23%, p=0.021), as were MTAP alterations (20% vs. 5.7%, p=0.026). Both genomic markers correlated with shorter OS as shown by survival curves. These findings suggest that despite generally favorable outcomes with ALK fusion NSCLC, a subset of patients harboring TP53 or MTAP mutations have significantly worse survival.<br /><br />The study concludes that survival in ALK fusion NSCLC is heterogeneous and influenced by genomic factors, indicating the need for further research to elucidate underlying biological mechanisms. Understanding these high-risk genomic profiles could drive personalized treatment strategies to improve outcomes for patients with ALK fusion NSCLC exhibiting poor prognosis markers.

Asset Subtitle

Karen Reckamp

Meta Tag

Speaker Karen Reckamp

Topic Pathology and Biomarkers

Keywords

ALK fusion

non-small cell lung cancer

NSCLC

survival analysis

TP53 mutation

MTAP alteration

tyrosine kinase inhibitors

genomic predictors

Kaplan–Meier survival

personalized treatment