Evaluation of tumor gene expression profile (GEP) in minority patients with stage IV non-small cell lung cancer (NSCLC).

Authors

null

Matthew Villanueva

Memorial Cancer Institute, Pembroke Pines, FL

Matthew Villanueva , Carlos Carracedo Uribe , Kayla Brice , Katerine Dumais , Olger Nano , Mitchelle Rodriguez , Elizabeth Osmon , Luis E. Raez

Organizations

Memorial Cancer Institute, Pembroke Pines, FL, Memorial Healthcare System, Pembroke Pines, FL, Memorial Hospital West, Pembroke Pines, Department of Hematology – Oncology, Memorial Cancer Institute, Hollywood, FL, Thoracic Oncology Program, Memorial Cancer Institute/Florida Atlantic University, Miami, FL

Research Funding

No funding received

Background: Differences in tumor gene expression profile (GEP) may contribute to disparities in lung cancer incidence and survival between racial and ethnic groups. For patients with stage IV NSCLC, tumor biomarker analysis is important for identification of potentially effective targeted therapies. However, despite advancements in biomarker testing and targeted therapy, minority patient enrollment in clinical trials remains low and it has been shown that minority patients are less likely to undergo next-generation sequencing (NGS) compared to Non-Hispanic Whites (NHW). As such, frequencies of tumor biomarkers in minority populations in the United States are not well-defined. This study aimed to determine the extent of tumor GEP diversity in minority patients vs NHW. Methods: This retrospective study included 196 adult patients with stage IV NSCLC that had a baseline NGS of tumor tissue or blood (liquid biopsy) performed between July 1, 2015 and June 30, 2021. Minority populations included Hispanic, African American, and Asian patients. Data collected utilizing the electronic medical record included patient demographics, detection of tumor biomarkers and treatment initiated. Descriptive statistics were calculated for all demographic and clinical variables. Comparisons of actionable epidermal growth factor receptor (EGFR) mutation frequency between NHW and minority patients were done using Chi-squared and Fisher’s exact tests. Results: Of the 196 patients evaluated, baseline characteristics included 46% male, 67% former smokers, 54% NHW, 31% Hispanic, 9% African American, 5% Asian, and 1% other. The median age at diagnosis was 66 ± 12 years. Actionable mutations (EGFR, KRAS, BRAF, ROS-1, ALK, MET, NTRK 1-3) were found in 50% of patients (see Table). The frequency of actionable EGFR mutations was higher in minority patients overall compared to NHW (39.3% vs 21.5%; p < 0.01). The frequency of actionable EGFR mutations was similar between NHW and Hispanic patients (21.5% vs 27.9%; p = 0.35), however differences were observed comparing NHW to African American (21.5% vs 50%; p = 0.02) and Asian (21.5% vs 90%; p < 0.01) patients, respectively. Conclusions: Among patients with stage IV NSCLC, the GEP of minority patients varied from that of NHW. Asian patients had the highest frequency of EGFR mutations, followed by African American and Hispanic patients, respectively. Larger studies are needed to validate these findings.

Distribution of actionable mutations by race and ethnicity.

Actionable MutationNHW (n = 107)Hispanics (n = 61)African Americans (n = 18)Asians (n = 10)
EGFR, n (%)23 (21.5)17 (27.9)9 (50)9 (90)
KRAS, n (%)10 (9.3)6 (9.8)1 (5.6)0 (0)
BRAF, n (%)4 (3.7)1 (1.6)0 (0)0 (0)
ROS-1, n (%)2 (1.9)2 (3.3)0 (0)0 (0)
ALK, n (%)1 (0.9)3 (4.9)0 (0)0 (0)
MET, n (%)5 (4.7)1 (1.6)0 (0)0 (0)
NTRK1-3, n (%)3 (3.8)1 (1.6)0 (0)0 (0)
Total48 (44.9)31 (50.8)10 (55.6)9 (90)

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e21043)

DOI

10.1200/JCO.2022.40.16_suppl.e21043

Abstract #

e21043

Abstract Disclosures

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