P35.19 The Mutational Landscape in South Asian Patients with Non-Small Cell Lung Cancer at an US Academic Medical Center

Abstract

Various molecular underpinnings of lung cancer have been noted in Asian populations, especially with targetable mutations such as EGFR and ALK (Doval et al., Ann Oncol 2014). However, the distribution and prevalance of these mutations have been less well characterized in South Asian/Indian patients, especially those who live outside of South Asia. We performed a retrospective review of NSCLC cases from 2005-2019, at Stanford Cancer Center, USA, and identified seventy-two patients who had a South Asian name. Their ethnicity was confirmed with manual review, with inclusion of patients noting origin from India, Pakistan, Bangladesh, or Sri Lanka. Patients were excluded if they did not have a confirmation of their ethnicity in the electronic medical record. Molecular testing data and type of methodology used for testing was also collected. 72 patients were identified from 2005-2019, of which 63 patients had mutational testing (from 2009-2019) performed. Of the 9 patients who had no mutational testing, 7/9 had non metastatic disease. Demographics and testing characteristics are shown in Table 1. 35 of 63 patients had targetable mutations (55.6%), with 21 patients with EGFR activating mutations (exon 19 deletion or exon 21 L858R) (33.3% of 63 patients).. Other mutations included 8 ALK rearrangements (12.7%), 6 KRAS mutations (9.5%), 2 ROS1 fusions (3.1%), and 2 BRAF V600E mutations (3.1%) (Figure 1). In assessing co-mutations, 3 ARID1A and 3 STK11 mutations were noted.Table 1N= 72Female37 (51%)Median age of diagnosis, years (range)64 (38-89)Non-Smoker62 (86%)Country of Origin/EthnicityIndia- 68 (94%) Pakistan- 3 (4%) Bangladesh-1 (1%)PathologyAdenocarcinoma- 63 (88%) Adenocarcinoma with Mixed Features- 4 (6%) Squamous (4%)Stage of DiseaseI or II- 12 (17%) I or II with recurrence- 7 (10%) III- 7 (10%) III with recurrence-1 (1%) IV-45 (63%)Type of TestingFluorescence in situ hybridization (FISH) only – 3 (4%) Next Generation Sequencing (NGS)- 34 (47%) Polymerase Chain Reaction (PCR) (includes ddPCR)- 27 (37.5%) Open table in a new tab South Asian patients, largely of Indian origin, with NSCLC at an US academic center appear to have a high chance of harboring a driver mutation, emphasizing the importance of molecular testing in this population. These findings corroborate rates of mutations reported from South Asia, and suggest similar trends in mutation prevalance despite different geographical locations. We are collaborating with an institution in Northern India to further compare and report on the molecular landscape of this population.