Common and rare EGFR mutations (EGFRm) in the RADIANT trial: Final follow-up with 5 year data.

Authors

null

Frances A. Shepherd

Princess Margaret Cancer Centre, Toronto, ON, Canada

Frances A. Shepherd , Wilfried Ernst Erich Eberhardt , Nasser K. Altorki , Mary E.R. O'Brien , Joe Wang , Jun Wu , Stan Gill , Kenneth Iwata , Frank C Richardson , Julie D. Horan , Margaret A. Foley , Karen Kelly

Organizations

Princess Margaret Cancer Centre, Toronto, ON, Canada, University Hospital - University Duisburg-Essen, Essen, Germany, Weill Medcl Coll of Cornell Univ, New York, NY, The Royal Marsden Hospital, Sutton, United Kingdom, Astellas Pharma Global Development, Northbrook, IL, Astellas Scientific and Med Aff Inc, Northbrook, IL, Astellas Scientific and Medical Affairs, Northbrook, IL, FC Richardson Consulting LTC, Louisville, CO, Novella Clinical Rsrch, Boulder, CO, Astellas Pharma Global Dev Inc, Northbrook, IL, UC Davis Comprehensive Cancer Center, Sacramento, CA

Research Funding

Pharmaceutical/Biotech Company

Background: Data on EGFRm in early stage NSCLC are limited. RADIANT was a prospectively randomized Phase 3 trial of adjuvant erlotinib (E) v placebo (P) in 973 patients (pts) with completely resected Stage IB–IIIA NSCLC that was EGFR +ve by IHC or FISH (ASCO14 #7501; ESMO14 #1178PD). Methods: EGFRm in exons 18–21 was determined by WAVE HS and confirmed by Sanger sequencing. Two EGFRm groups were defined: Common refers to exon del19 or L858R irrespective of the presence of another EGFRm; Rare Only refers to EGFRm without del19 or L858R. Exploratory analysis of disease-free survival (DFS) was performed by subgroup (June 11, 2014 data cutoff). Results: 921 pts had EGFRm status determined; 198 pts (21.5%) had EGFRm (161 Common, 37 Rare Only). There was no sex difference between the groups, but pts with Rare Only EGFRm were less likely to be Asian (32.4% v 47.2%) or non-smokers (48.6% v 62.7%). With a median follow-up of 5 years, updated DFS by mutation type is shown below. The DFS HR was lower in the Common group (HR [E/P] 0.75, CI 0.48, 1.16) than in the Rare Only group (HR 1.19, CI 0.44, 3.22). Conclusions: The effect of E on DFS in EGFRm subgroups remains inconclusive. Clinical trial information: NCT00373425

EGFRm (n) SubgroupArmnDFS
EventsMedian (m)HR (E/P), 95% CI
Common* (161):Del 19/L858RE
P
102
59
49
34
47.8
28.5
0.75 (0.48–1.16)
Del 19E
P
56
33
29
19
46.4
26.4
0.82 (0.46–1.46)
L858RE462054.10.68 (0.35–1.34)
P261529.3
Rare Only (37):AllE
P
19
18
7
9
NR
46.5
1.19 (0.44–3.22)
Exon 20 (21)E
P
11
10
4
6
NR
40.7
0.96 (0.27–3.43)
Rare Only (n)**DetailArmnDFS Min, Max
Exon 18 G719X (8)G719A, G719A+E709A,
G719A+E709K
E50.0+, 58.0+
G719AP339.7+, 47.6+
Other Exon 18 (4)L692, G719A+E709A,
G719A+E709K
E30.0+, 28.2
V689LP159.7+
Exon 19 (2)
R748TE154.4+
L747SP157.5+
Exon 20 Ins_dup (17)A767_S768Ins,
H773_V774ins,
V774_C775ins,
A767_V769dup,
N771_H773dup,
P772_H773dup
E100.0+, 54.5+
N771_H773dup,
P772_H773ins,
A767_V769dup,
A763_Y764ins,
H773dup
P716.2, 59.7+
Exon 20 other (4)S768IE158.0+
R776H, S768I+V774M,
R776H
P339.7+, 64.0+
Exon 21 (8)L861Q, E868KE21.9, 42.1+
D830N, L861Q,
L844P, V845E
P61.8, 58.3+

NR = Not Reached. *Includes 12 pts with another EGFRm in addition to del19 or L858R. + Indicates censoring; **Pts may have > 1 rare EGFRm.

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Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT00373425

Citation

J Clin Oncol 33, 2015 (suppl; abstr 7539)

DOI

10.1200/jco.2015.33.15_suppl.7539

Abstract #

7539

Poster Bd #

286

Abstract Disclosures