EP1.03-34 Single Center Epidemiological Prevalence Study of Molecular Mutation in Bangladeshi Patients with Advanced Stage Non-Small Cell Lung Cancer

Abstract

In a private tertiary hospital of Bangladesh about 2953 patients have been diagnosed as primary cancer patient of which 17% (510) patients were primary lung cancer patients, 77% of which were in advanced (stage III and IV). The study was performed to investigate the molecular mutations and prevalence of EGRF, T-790M, ROS-1, and ALK mutations in Bangladeshi patients with advanced stage non-small cell lung cancer (NSCLC), as per available local molecular lab facilities. This study was retrospective and single center, conducted in 35 patients representing the 77% advanced stage lung cancer patients aged 20 years or above with NSCLC in the outpatient department The Bangladesh Specialized Hospital Ltd. (BSHL) within the timeframe of March 2016 – March 2019 recommended for molecular mutation study. Data were collected from the electronic prescription from hospital imformation system. EGFR, T-790M, ROS-1, and ALK frequency were calculated. The tests were done by tissue sample or Liquid biopsy when tissue sample was unavailable. The tests were carried out by Real Time PCR. The frequency of molecular mutation diagnosis was compared between the number of patients advised for molecular mutation study and number of patients who performed the investigation. Of 35 patients 63% (22) were male and 37% (13) were female, median age 61 (range 45-86) and 65% (23) test carried out with Liquid Biopsy. 25.7% (9) patients were found to be EGFR positive, and 74.3% (26) were EGFR negative; also, out of 16 patients recommended for T790M study only 6.3% (1) was positive. ROS positive was found in 40% (14), and 48.6% (17) were negative. ALK screening showed to be positive in 37.1% (13) and negative in 45.7% (16). Among the 392 patients, only 9% performed the study, due to low availability of moleculer diagnosis which was started in Bangladesh since the early July 2017. The frequency of molecular testing may not reflect the international studies due to methods applied for the testing and also with the gender frequency as high predominance of male patients. With this limited data we have seen that the prevalence of ROS-1 (40%) mutation was higher than ALK (37.1%) and EGFR (25.7 %). Due to financial constrain and limited access to tests only 9% patients performed the study, though, molecular tests are recommended most oftenly. Due to time being a limiting factor for the sample size further studies can be performed on a larger scale.