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• W2982029042 abstract "Identifying targetable genomic drivers is critical for optimal first-line treatment planning in aNSCLC. ctDNA testing can aid treatment selection when tissue specimens are inadequate for complete genotyping or when a rapid turnaround time is advantageous. Targeted therapy (TT) outcomes for ctDNA-detected drivers have not been widely reported in the first-line setting given the relatively recent adoption of this technology into clinical practice. We conducted a multicenter retrospective review of patients with aNSCLC who received matched TT following identification of a driver on a validated commercial ctDNA assay (Guardant360). Eligible patients were tested per regular clinical care between March 2014-October 2018 and must not have received a TT prior to ctDNA testing (prior chemotherapy or immunotherapy was permitted). Kaplan-Meier analysis was used to estimate median duration of TT (DTT) for both the first and all subsequent sequential targeted therapies where applicable (e.g. osimertinib following erlotinib). Patients still on TT were censored at last follow-up. 76 patients met inclusion criteria. Median age of diagnosis of aNSCLC was 64.5 years (range 31-87y), 67% were female, 74% were never smokers, and 97% had adenocarcinoma histology. 21/76 (28%) patients received chemotherapy (n=17), immunotherapy (5), and/or a biologic (4) prior to receiving TT. 41/76 (54%) patients remain on TT at the time of data analysis, 32 of whom are still on their first TT. 38/41 patients still on TT have at least 6 months follow-up. Treatment outcomes are summarized in Table 1.Table 1Duration of Targeted TherapyDriverTherapyn, total patients/discontinued therapyMedian (95% CI) DTT in weeks1EGFRErlotinib Osimertinib Afatinib Gefitinib Any EGFR TKI221 / 19 23 / 6 3 / 2 1 / 1 48 / 2033 (23-54) NR 3, 13, 93* 63 86 (48-197)ALK fusionAlectinib Crizotinib Any ALK TKI37 / 2 2 / 2 9 / 2NR 20, 44 NRBRAF V600EDabrafenib + Trametinib10 / 751 (13-88)MET exon 14 skippingCrizotinib Investigational3 / 2 1 / 14, 77, 63* 14ROS1 fusionInvestigational2 / 150, 79*ERBB2 exon 20 insertionAdo-trastuzumab emtansine2 / 146, 14*RET fusionInvestigational1 / 1471 – individual data rather than median provided for counts <5 2 – includes 15 patients receiving sequential EGFR TKIs 3 – includes 3 patients receiving sequential ALK TKIs * indicates therapy is ongoing for individual data points Abbreviations: NR – not reached; TKI – tyrosine kinase inhibitor Open table in a new tab 1 – individual data rather than median provided for counts <5 2 – includes 15 patients receiving sequential EGFR TKIs 3 – includes 3 patients receiving sequential ALK TKIs * indicates therapy is ongoing for individual data points Abbreviations: NR – not reached; TKI – tyrosine kinase inhibitor This study provides interim data on targeted therapy outcomes for aNSCLC patients with Guardant360-detected drivers treated in everyday clinical practice. Outcomes are in line with what is expected for tissue-detected drivers in the TT naïve setting and this cohort will continue to be followed. Identification of NSCLC driver mutation using well-validated ctDNA assays can be used for clinical decision-making." @default.
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• W2982029042 date "2019-10-01" @default.
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• W2982029042 title "P1.14-27 Duration of Targeted Therapy in Advanced NSCLC (aNSCLC) with Drivers Identified by Circulating Tumor DNA (ctDNA) Analysis" @default.
• W2982029042 doi "https://doi.org/10.1016/j.jtho.2019.08.1178" @default.
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