Tumori Journal Abstract Book - October 2020 - 11

A - Thoracic Cancers	
response was assessed by CT-scan after 2-3 months (mos)
as per RECIST 1.1 criteria. FDG-PET parameters (maximum standardized uptake value [SUVmax], SUVpeak,
lean body mass corrected SUV [SULpeak], total lesion
glycolysis [TLG]) cut-offs were calculated using ROC
curve analysis.
Results: 23 pts with adv-EGFR+ NSCLC (1L=15;
2L=8) were enrolled at the time of data cut-off (April
21th, 2020). Overall, mPFS was 7.1 mos (95% CI, 0.313.9) and mOS was not reached (Range, 1.1-17.9). Basal
shedders had a significantly shorter mPFS compared to
non-shedders (mPFS: 3.6 vs 17.0 mos, p<0.05). Among
all FDG-PET parameters, basal TLG (bTLG) was significantly related to basal EGFRact AF (Spearman r:
0.57, 95%CI 0.17-0.81, p<0.05). Pts who had a high
bTLG had a significantly shorter mPFS vs pts with a low
bTLG (mPFS: 3.6 vs 14.2 mos, p<0.05). Pts who had a
high bTLG and were shedders had a significantly shorter
mPFS vs pts who had only 1 of the 2 features and who
had none (mPFS: 3.0 vs 7.1 vs 17.0 mos, respectively,
p<0.05). Mean SUVmax, SUVpeak, SULpeak and
median TLG of the entire population were significantly
decreased after 1 month of osimertinib (all p<0.05),
similarly to median EGFRact AF. Among basal shedders
(n=12), the clearance of EGFRact after 1 month was significantly associated with MR (p<0.05). Pts who
achieved a MR at the 1-month FDG-PET had a significantly longer mPFS vs pts who did not (mPFS: 14.2 vs
5.5 mos, p<0.05).
Conclusions: EGFRact shedding and high bTLG identified a poor responder group to osimertinib. Integration of
basal and early cfDNA analysis and metabolic parameters
might be a promising not-invasive approach to predict
benefit to osimertinib.

A13
Detection of KRAS mutational
status by next-generation
sequencing (NGS) of cell-free
circulating tumor DNA (ctDNA)
in Non-Small Cell Lung Cancer
(NSCLC) in the basal setting
Gristina V.1, Malapelle U.2, Galvano A.1, Bazan V.3, Troncone G.2,
Russo A.4
1
Department of Section of Medical Oncology, Department of Surgical,
Oncological and Oral Sciences, University of Palermo, Palermo; 2Department
of Public Health, University Federico II of Naples, Naples; 3Department of
Experimental Biomedicine and Clinical Neurosciences, School of Medicine,
University of Palermo, Palermo; 4Department of Section of Medical
Oncology, Department of Surgical, Oncological and Oral Sciences, University
of Palermo, Palermo

Background: In advanced Non-Small Cell Lung Cancer
(NSCLC) patients, Kirsten Rat Sarcoma Viral Oncogene

11
Homolog (KRAS) testing may soon acquire a predictive
significance to select patients for AMG510 treatment.
Since obtaining tissue biopsies for molecular analysis has
resulted to be challenging and/or tissue specimens are
often rejected for insufficient cellularity, liquid biopsy
may represent a viable option for KRAS testing.
Methods: We retrospectively analyzed the last three years
clinical practice performed on 194 plasma-based liquid
biopsies by a customized next-generation sequencing
(NGS) narrow panel. In addition to automatic variant calling analysis, we took into account several run metric
parameters while Binary Alignment Map (BAM) files
were visually inspected to assess the robustness and the
reliability of this NGS panel on blood.
Results: Namely, 36 (18.6%) KRAS-mutated cases were
identified, with an overall median allelic frequency of
5.0% (ranging between 0.2% and 46.8%). No concomitant
mutations were observed in the other NSCLC clinically
relevant genes included in the NGS panel, such as epidermal growth factor receptor (EGFR) and v-Raf murine sarcoma viral oncogene homolog B (BRAF). Exon 2 p.G12C
was the most common detected mutation (13/36, 36.1%).
Conclusions: This is the first study demonstrating the
technical feasibility of assessing KRAS mutational status (and particularly the exon 2 p.G12C point mutation)
by using an NGS approach on plasma samples of treatment-naïve advanced NSCLC patients. Further investigation is required to design more cost-effective
diagnostic algorithms to harmonize clinically relevant
biomarker testing on tissue and blood in advanced
NSCLC clinical practice.

A14
Smoking habit and NGS-based
molecular profiling in 'triplenegative' (EGFR/ALK/ROS1) advanced
non-small-cell lung cancer
(aNSCLC)
Simionato F.1, Calvetti L.2, Pancheri F.2, Scarparo S.3, Frugoni P.3,
Cosci M.4, Andrea Giovanni M.5, Ave S.6, Lupi A.6, Aprile G.2
1

Oncologia - Ospedale San Bortolo, AULSS8 Berica, Vicenza; 2Oncologia
Ospedale San Bortolo, AULSS8 Berica, Vicenza, Vicenza; 3Pneumologia
Ospedale San Bortolo, AULSS8 Berica, Vicenza, Vicenza; 4Chirurgia Ospedale
San Bortolo, AULSS8 Berica, Vicenza, Vicenza; 5Anatomia Patologica
Ospedale San Bortolo, AULSS8 Berica, Vicenza, Vicenza; 6Medicina Nucleare
Ospedale San Bortolo, AULSS8 Berica, Vicenza, Vicenza

Background: Although promising, the impact in the clinical practice of upfront multi-gene profiling in advanced
non-small-cell lung cancer (aNSCLC) is not yet well
defined.
Methods: From July 2018 to December 2019, NGS analyses were conducted on "triple negative" (EGFR/ALK/
ROS1) aNSCLC patients. The analyses were conducted on



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
Tumori Journal Abstract Book - October 2020 - 1
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