WCLC 2025 - Posters & ePosters-P1.17.61 Rebiopsy in Oncogene-Driven Lung Cancer: Real-World Practices in ALK, EGFR, and ROS1 Cohorts in the Australian AURORA Longitudinal Cohort Study

P1.17.61 Rebiopsy in Oncogene-Driven Lung Cancer: Real-World Practices in ALK, EGFR, and ROS1 Cohorts in the Australian AURORA Longitudinal Cohort Study

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This study analyzes real-world biopsy and re-biopsy practices in oncogene-driven non-small cell lung cancer (NSCLC) patients with EGFR, ALK, and ROS1 mutations, utilizing data from the Australian AURORA longitudinal cohort (Jan 2012–Feb 2025). It included 281 patients (105 EGFR, 141 ALK, 35 ROS1) undergoing a total of 622 biopsies. Biopsies were categorized by timing: diagnostic, on-treatment, progression, resection, and surveillance. Most samples were tissue biopsies (62%), with fewer cytology (36%) and rare liquid biopsies (2%).<br /><br />Key findings include that all patients had diagnostic biopsies, while re-biopsy at disease progression occurred in 56% of patients overall. When broken down by mutation type, re-biopsy rates at progression were highest in the EGFR cohort (75%), followed by ROS1 (57%), and lowest in ALK patients (41%). The ALK group also had a higher rate of biopsies during surgical resection (35%) compared to EGFR (22%) and ROS1 (14%). No surveillance biopsies were done in the ROS1 cohort.<br /><br />Significantly, re-biopsy frequency at progression increased over time, from 51% in earlier years to 70% more recently (p=0.04), reflecting growing recognition of biopsy importance for personalized treatment. Re-biopsies provide critical information on tumor status and mechanisms of resistance, informing targeted treatment decisions. Variability in biopsy practices among mutation subgroups highlights areas to optimize clinical workflows.<br /><br />In conclusion, this large real-world cohort study demonstrates increasing use of re-biopsy at progression in oncogene-driven NSCLC, underscoring its role in managing resistance and guiding precision oncology. The findings support continued efforts to standardize and expand biopsy practices to improve treatment personalization and outcomes in patients with EGFR, ALK, and ROS1 mutations.

Asset Subtitle

Susan Harden

Meta Tag

Speaker Susan Harden

Topic Global Health, Health Services, and Health Economics

Keywords

non-small cell lung cancer

NSCLC

oncogene-driven

EGFR mutation

ALK mutation

ROS1 mutation

biopsy practices

re-biopsy

tumor resistance

precision oncology