22P Next generation sequencing-based molecular profiling of lung carcinoma: A routine care experience

Lung cancers belong to tumors with the highest incidence and mortality. Molecular characterization and assessment of actionable gene mutations and oncogene fusions makes a paradigm shift in a treatment strategies of these tumors. The introduction of advanced sequencing techniques such as next generation sequencing (NGS) becomes a key tool for facilitating treatment decisions and the clinical management of lung cancer patients. We used targeted NGS in a routine practice for identifying clinically relevant molecular alterations in non-small-cell lung cancer (NSCLC) patients. 190 NSCLC patients treated in our hospital were included into the study. Tumor histopathological evaluation was done according to the current classification. Mutation analysis and fusion transcript detection in FFPE tumor samples were performed using the Archer FusionPlex Comprehensive Thyroid and Lung (CTL) targeted NGS panel (ArcherDX Inc, Boulder, USA). Mutations were detected in 60 patients (31%), 31 men and 29 women in the age range 26 - 91 years. The most common mutated gene was KRAS (30 pts) followed by EGFR (20 pts), HRAS (2 pts), MET (2 pts), and individual mutations were observed in BRAF, PIK3CA, ERBB2, IDH1 and CTNNB1. Oncogene fusions were identified in 13 patients (6.84%), 8 men and 5 women in the age range 27 - 81 years. Among the clinically most relevant fusions were identified ALK fusions (3 pts), ROS fusions (3 pts), and RET fusion (1 pt). 9 patients with detected EGFR mutations received targeted treatment. In additional 5 patients the targeted therapeutics are planned. Targeted treatment was administrated to 5 patients with detected gene fusions, mainly ALK and ROS1, in one patient the targeted therapy is planned. The introduction of sequencing techniques brings the relevant information about actionable molecular alterations into the multimodal management of lung cancer patients. As we showed in our study, the use of targeted NGS panel is a reliable approach for NSCLC molecular profiling and can be applied in personalized treatment decision making in routine clinical care of lung cancer patients.