P37.04 EGFR Mutations in US Hispanics with Lung Adenocarcinoma are Common and Portend a Worse Prognosis

Abstract

Activating mutations in Epidermal growth factor receptor (EGFR) occur in approximately 15% White, 40-50% of Asian and 15% of Black patients with lung adenocarcinoma. However, its prevalence in the nearly 60 million U.S. Hispanics has not been well characterized. Herein we evaluate EGFR mutation frequency in U.S. Hispanic patients with lung adenocarcinoma at an academic institute serving a large multi-ethnic area. We queried our prospective database (2015-19) for lung adenocarcinoma patients who underwent resection and had routine mutational analysis by a targeted gene panel. We identified 768 patients and were able to stratify 668 patients by self-identified race/ethnicity. We compared demographics (chi-square) and survival (Kaplan-Meier). 668 patients representing White, Hispanic, Asian and Black patients were identified. 200/668 patients had an activating EGFR mutation. Hispanic patients displayed a higher frequency of EGFR mutations than Whites (35% vs. 20%, p=0.013) Table 1. Hispanic patients were less likely to be smokers than White patients (60% vs. 82%, p=0.015). Hispanic EGFR mutant patients had worse 3-year overall survival than White and Asian patients (3 year OS: 62% vs. 96% & 90%, respectively p= 0.021 & 0.075; median f/u = 24.4 months) Figure 1A. Hispanic EGFR wild-type patients had a similar 3 year OS to other racial/ethnic groups and had improved 3 year DFS compared to Asian patients (3 year OS: 92% vs 85% and 92%, p= ns; and DFS 85% vs 76% and 63%, p=0.048) Figure 1B. EGFR mutations were similar across groups Figure 1C. Approximately one-third of U.S. Hispanics with lung adenocarcinoma displayed EGFR mutations which were associated with decreased survival compared to White and Asian patients. Increasing mutational analysis and investigation of biological differences of this growing ethnic group is essential for optimal neoadjuvant and adjuvant treatments as well as in the design of future clinical trials.View Large Image Figure ViewerDownload Hi-res image Download (PPT)