LBA31 - Concomitant Actionable Mutations and Overall Survival (OS) in Egfr-Mutant Non-Small-Cell Lung Cancer (NSCLC) Patients (P) Included in The Eurtac Trial: EGFR L858R, EGFR T790M, TP53 R273H and EML4-ALK (V3)

Abstract

ABSTRACT Background At the final cutoff of April 2012, in the randomized phase III EURTAC trial, erlotinib improved progression-free survival (PFS) in comparison with chemotherapy as first-line treatment in European p with EGFR-mutation-positive NSCLC (HR, 0.34; P Methods We have assessed EGFR T790M and TP53 mutations, the EML4-ALK translocation and BIM mRNA expression in pretreatment tumor samples of 95 p from the EURTAC trial and correlated our findings with outcome. Results Concomitant T790M was found in 37.89%, TP53 in 24.21% and EML4-ALK in 15.8% of p. BIM expression was low or intermediate in 55.8% of p and high in 31.6%. 86.7% of the 45 p receiving chemotherapy had crossed over to receive EGFR TKIs at the time of progression. In p treated with erlotinib, overall response rates (ORR) were 87.5% in p with high BIM expression and 34.6% in p with low/intermediate BIM; ORR in the chemotherapy group were 11.1 and 14.2, respectively (P = 0.0002). Among p in the erlotinib group without T790M mutations, ORR was 100% for p high BIM expression vs 35.2% for p low/intermediate BIM levels (P = 0.01). In the multivariate analysis, only erlotinib (HR, 0.36; P Conclusions Our results can lead to the design of studies of treatment based on the presence of the EGFR T790M mutation and BIM expression levels. We are currently designing a clinical trial based on our findings. Disclosure All authors have declared no conflicts of interest.