EP101-35 Concurrent Use of Low Dose Aspirin and Vitamin D in ALK, ROS and EGFR Mutant NSCLC: A Single Institution Retrospective Analysis

Recent meta-analysis published by Feng et al. analyzed seventeen studies and reported statistically significant reduction in risk of lung cancer by 8% when circulating 25-VD is at 10 nmol/L, this benefit was seen in both Caucasian and Asian population. To our knowledge, there have been no studies looking at influence of concurrent vitamin D or aspirin intake on outcomes in ALK, ROS and EGFR pos NSCLC treated with tyrosine kinase inhibitors. We performed a retrospective single institution analysis to study this association.Patients (pts) with ALK, ROS EGFR pos NSCLC treated with first line TKI from January 2014 to June 2017 were included. Information on concurrent use and doses of aspirin and vitamin D supplements were studied. Patients were dichotomized based on use of these individual supportive medications. Two sample t-test was used to compare mean PFS and chi-square test to compare proportions of disease control rate (DCR) at 3 months between groups.Our study did not show any diffe..... READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.2008

Authors: C. Bernabe, S. Sharma, J. Sanchez, K. Sullivan, N. Seetharamu

Conference PaperKirk SmithOctober 1, 2019PFS, DCR, EGFR, ROS, ALK positive, NSCLC, vitamin D, aspirin, TKI

P214-51 Dual ALK Fusion Partners as Poor Predictive Marker in First Line Crizotinib Treated ALK Rearranged Non-Small Cell Lung Cancer

Background: First line crizotinib response duration time differs with different fusion patterns in ALK-rearranged advanced non-small cell lung cancer (NSCLC) patients. Some former researches have elucidate the impact of EML4-ALK variants on crizotinib efficacy, however, there was little data about the efficacy of crizotinib considering different fusion partners including one patient with two or more fusion partners or non-EML4 partners. Conclusion: Efficacy of first-line crizotinib in ALK-rearranged NSCLC patients differs based on different ALK fusion partners. Dual ALK fusion partners were poor prognostic factors in first-line crizotinib treatment NSCLC. It also correlated with more brain metastasis compared with single fusion partners. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.1836

Authors: Y. Zhang, L. Zeng, N. Yang, T. Jiang, C. Zhou

Conference PaperKirk SmithOctober 1, 2019Next Generation Sequencing, ALK, Fusion partners, crizotinib

MA21.05 Phase II Trial of the Combination of Alectinib with Bevacizumab in ALK-Positive Nonsquamous Non-Small Cell Lung Cancer

Alectinib is a 2nd generation highly selective anaplastic lymphoma kinase (ALK) inhibitor. Although alectinib has improved progression-free survival (PFS) in patients with ALK-positive Non-Small Cell Lung Cancer (NSCLC), there are limited treatment options after progression of alectinib. Recent evidences have described promising results of the combination of bevacizumab with EGFR-TKIs, cytotoxic chemotherapies and immune-checkpoint inhibitors. We report the results from a phase II study of the combination of alectinib with bevacizumab in ALK-positive Nonsquamous NSCLC patients who were treated with alectinib and showed disease progression (UMIN 000017828) READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.676

Authors: S. Watanabe, N. Matsumoto, J. Koshio, A. Ishida, T. Tanaka, T. Abe, D. Ishikawa, S. Shoji, K. Nozaki, K. Ichikawa, R. Kondo, A. Otsubo, A. Aoki, T. Kajiwara, K. Koyama, S. Miura, H. Yoshizawa, T. Kikuchi

Conference PaperKirk SmithOctober 1, 2019alectinib, ALK, Bevacizumab, clinical trial

ALK Testing in Chinese Advanced NSCLC Patients: A National-Wide Multicenter Prospective Real-World Data Study (The RATICAL Study)

Background: ALK-tyrosine kinase inhibitors increase ORR and PFS times in ALK-fusion positive NSCLC patients. It is therefore crucial to assess the efficacy of different methods for detecting ALK rearrangement. At present, there are most testing methods approved by cFDA to detect ALK rearrangement in China. However, many issues regarding to the procedure and quality control (QC) data of ALK testing in the routine clinical practice is still to be studied. This study is to evaluate the ALK testing platforms, testing procedures, result interpretation quality control and clinicopathological characteristics of ALK positive patients in the real world for Chinese lung cancer patients, and achieve expert consensus on the clinical practice of ALK testing. Conclusion: NSCLC patients harboring ALK gene translocation have unique clinicopathological characteristics. Some problems will still be encountered in the real world clinical practice of ALK testing, which need to be guided by establishment of expert consensus. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.1034

Authors: J. Ying, L. Li, W. Li, Y. Li, Q. Xia, X. Teng, Y. Liu, G. Chen, X. Qiu, W. Wu, Ji, Z. Wang, X. Yan, Y. Han, A. The Ratical Study Group

Conference PaperKirk SmithOctober 1, 2019Lung cancer, Real world data, ALK testing

P109-32 Concurrent Genomic Alterations in ALK-Rearranged Non-Small Cell Lung Cancer Patients

Background: Recent progress in genomic analysis using next-generation sequencing (NGS) has enabled the comprehensive detection of targetable alterations in non-small cell lung cancer (NSCLC) patients. As the detection of ALK gene fusions is being established by NGS, identification of concurrent alterations will lead to better characterization of the molecular landscape of ALK-rearranged patients. Conclusion: We have studied the presence of ALK fusion genes with a novel NGS panel that showed excellent correlation with standard techniques. ALK fusions can be interpreted as early strong drivers to carcinogenesis due to the low frequency of concurrent alterations. It remains to determine the clinical impact of these alterations in larger series. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.1061

Authors: S. Clavé, M. Salido, J. Gibert, M. Hardy-Werbin, E. Weingartner, J. Hernandez, D. Nichol, P. Rocha, X. Riera, R. Blanco, J. Bosch-Barrera, Á. Taus, L. Pijuan, B. Bellosillo, E. Arriola

P114-47 ctDNA NGS for Guiding Crizotinib Treatment in ALK-Rearranged Advanced NSCLC Patients (Pts)

Background: FISH and IHC are commonly used and the golden standard for testing ALK rearrangement. However, they provide no information on fusion types or mutation status of other genes, which could be important prognostic factors. In addition, a tissue biopsy is not always applicable/preferred by pts. Conclusion: Information on ALK fusion types, concomitant mutations, and mutation frequencies provided by NGS could be valuable prognostic factors and deserves further investigation. ctDNA NGS could be used as an effective alternative to identify ALK+ pts, especially for elderly pts, when tissue biopsy is inapplicable or not preferred. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.1198

Authors: Y. He, J. Zhao, C. Liu, R. Chen, X. Xia

Conference PaperKirk SmithOctober 1, 2019ALK, crizotinib, ctDNA

P214-38 ATAD2B-ALK, a Novel Fusion in Lung Adenocarcinoma Identified Using Next-Generation Sequencing (NGS)

Background: Anaplastic lymphoma kinase (ALK) rearrangements is an important molecular subtype of non-small cell lung cancer (NSCLC), and patients with this variant are sensitive to ALK inhibitors. Since the discovery of the EML4-ALK fusion ten years ago, several fusion partners of ALK in NSCLC have been reported, including KIF5B, KLC1, HIP1, TPR and so on. According to previous reports, different fusion partner lead to various function and activity of the fusion product. Here, we identified a novel fusion partner for ALK in a lung adenocarcinoma patient. Conclusion: The novel ALK fusion gene probably served as oncogenic driver of the patient’s tumor. This case is the first report of ATAD2B-ALK fusion in clinical tumor samples and could provide a new diagnostic and therapeutic candidate target for patients with lung cancer. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.1823

Authors: H. Bai, W. Jia, X. Jin, H. Mao, D. Wu, R. Chen, X. Xia, H. Wu

Conference PaperKirk SmithOctober 1, 2019ALK, ATAD2B, ALK rearrangement, NGS, lung adenocarcinoma

EP109-17 Spanish Lung Cancer Biomarker Testing Registry (Lungpath): Descriptive Analysis Focus in ALK Traslocation Results

Biomarker testing on pathology specimens is an essential requirement to properly treat lung cancer (LC) patients. LungPath is an on-line tool developed by the Spanish Society of Pathology (SEAP) with free and voluntary participation of differents Departments of Pathology to registry, monitor and trace biomarker results in clinical practice. After initial data reclutation step, first objective is to realize a descriptive analysis of LungPath focusing on ALK traslocation testing. Descriptive analysis of the LungPath registry. Biomarkers determinations of LC patients were collected from March 2018 to January 2019, from 38 Spanish Departments of Pathology. Development of central biomarker databases, such as Lungpath, provide an opportunity to registry clinical practice data and in the future could be an useful tool to monitor, correlate results between different centers and improve the available knowledge regarding biomarkers in LC. According the international guidelines, EGFR mutation and..... READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.2213

Authors: J. Martin Lopez, L. Aduz Alexandre, S. Gatius Caldero, A. Navarro Gonzales, P. Saiz Lopez, C. Gomez Bellvert,, C. Camacho García, L. Melgar, E. Costa Navarro, I. Abdulkader Nallib, C.A. Vasquez Dongo, M. Saiz Camin, A. Yagüe Hernando, L. Atienza Cuevas, L. Pijuan, T. Hernández Iglesias, A. Martinez Pozo, C. Salas Anton

Conference PaperKirk SmithOctober 1, 2019ALK, Targeted therapy, Biomarker

Circulating tumor (ct) DNA analysis to monitor response and resistance to ensartinib in patients (pts) with ALK+ non-small cell lung cancer (NSCLC)

Background: Pts with anaplastic lymphoma kinase (ALK)-rearranged NSCLC have benefited from ALK tyrosine kinase inhibitors (TKIs); however, most pts eventually acquire resistance. Identification of resistance mutations informs subsequent therapy but has typically required invasive repeat biopsies. Here, we assessed the utility of ctDNA analysis and the ability to monitor response longitudinally and detect resistance mutations during therapy with ensartinib, a potent second-generation ALK TKI. Conclusions: Overall, the data suggest that plasma ctDNA analysis can potentially identify a subgroup of pts with ALK+ NSCLC who may derive clinical benefit from ensartinib. Furthermore, serial assessments of ctDNA during therapy offer a convenient method to track tumor response and identify the mutational landscape of acquired resistance. READ ARTICLE

Annals of Oncology DOI:10.1093/annonc/mdz063.010

Authors: L. Horn, J. G. Whisenant, H. Wakelee, K. L. Reckamp, H. Qiao, L. Du, J. Hernandez, V. Huang, S. N. Waqar, S. Patel, R. E. Sanborn, T. Shaffer, K. Garg, A. Holzhausen, K. Harrow, C. Liang, L. P. Lim, M. Li, C. M. Lovly