Clinical impact of the rapid genomic screening platform for non-small cell lung cancer in Asia-Pacific (LC-SCRUM-AP).

Abstract

8637 Background: In 2013, a lung cancer genomic screening project (LC-SCRUM-Asia) started in Japan and expanded to other Asia-Pacific countries in October 2022 (LC-SCRUM-AP). The objective of this study is to clarify the characteristics of genomic profile in Asia-Pacific countries outside of Japan and to elucidate the clinical significance of rapid genomic screening. Methods: To shorten the turnaround time (TAT), a central laboratory was set in each participating country. Samples are analyzed by a multi-gene PCR assay and a rapid next-generation sequencing assay. Clinical, pathological and genomic data are stocked as a clinical-genomic database in each participating country, which is combined with Japanese database and the integrated clinical-genomic database of the Asia-Pacific region was established. Results: A multi-gene PCR assay data was available in 7879 samples from 4 Asia-Pacific countries (Taiwan/Thailand/Malaysia/Japan = 126/65/30/7658 pts). The rates of driver alterations in never-smokers with non-squamous histology were similar in the 4 Asia-Pacific countries: 83%, 80%, 89% and 75% in Taiwan, Thailand, Malaysia, and Japan, respectively. The pattern of genomic profile was also similar among these 4 countries. The median TAT was 4 days and 5 days in Japanese cohort and Taiwan/Thailand/Malaysia cohort, respectively. In Taiwan/Thailand/Malaysia cohort (n = 221), the genomic analysis successful rate was 99.5%. The rates of genomic alterations detected: EGFR (35%) of which ex20ins (6%), KRAS (10%) of which G12C (4%), ALK fusions (6%), ROS1 fusions (4%), RETfusions (0.5%), HER2ex20ins (4%), MET ex14skip (3%), BRAF V600E (1.5%), and NTRK3 fusions (0.5%). Oncogenic driver alterations were detected in 149 pts, of which 102 (68%) pts received targeted therapies approved in each country. 14 patients were enrolled into clinical trials of the investigational drugs, of which 5 were for targeting rare driver alterations. Conclusions: LC-SCRUM-AP is the first international genomic screening platform established in the Asia-Pacific region, which enables the efficient detection of rare driver alterations with a short TAT, contributing to the high implementation rate of targeted therapies. The similar pattern of genomic profile in the 4 Asia-Pacific countries indicates the utility of this screening platform as the basis for the clinical trials for NSCLC with rare driver alterations. We plan to further expand the number of institutions and participating countries.