Elisa Gobbini1, Domenico Galetta2, Marcello Tiseo3, Paolo Graziano4, Antonio Rossi5, Emilio Bria6, Massimo Di Maio7, Giulio Rossi8, Vanesa Gregorc9, Ferdinando Riccardi10, Vieri Scotti11, Anna Ceribelli12, Lucio Buffoni13, Angelo Delmonte14, Tindara Franchina15, Maria Rita Migliorino16, Diego Cortinovis17, Salvatore Pisconti18, Paola Bordi3, Annamaria Catino2, Evaristo Maiello19, Francesca Arizio20, Silvia Novello20. 1. Department of Oncology, University of Turin, AOU San Luigi, Regione Gonzole 10, 10043 Orbassano, Italy. Electronic address: elisa.gobbini@hotmail.it. 2. Medical Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", Via Orazio Flacco 65, 70124 Bari, Italy. 3. Medical Oncology Unit, University Hospital, Via Gramsci 14, 43123 Parma, Italy. 4. Pathology Unit, Scientific Institute for Research and Health Care (IRCCS) "Casa Sollievo della Sofferenza", Viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy. 5. Division of Medical Oncology, S.G. Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; Oncology Unit, Scientific Institute for Research and Health Care (IRCCS) "Casa Sollievo della Sofferenza", Viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy. 6. Oncology Unit, Department of Medicine, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy. 7. Oncology Unit, University of Turin, Mauriziano Umberto I, Via Magellano 1, 10128 Turin, Italy. 8. Pathology Unit, University Hospital, Largo del Pozzo 71, 41125 Modena, Italy. 9. Department of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, San Raffaele Hospital, Via Olgettina Milano 60, 20132 Milano, Italy. 10. Oncology Unit, Antonio Cardarelli Hospital, Via Antonio Cardarelli 9, 80131 Napoli, Italy. 11. Radiotherapy Unit, University Hospital Careggi, Largo Brambilla 3, 50134 Firenze, Italy. 12. Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Roma, Italy. 13. Medical Oncology Unit I, University Hospital Città della Salute e della Scienza, Corso Bramante 88, 10126 Turin, Italy. 14. Thoracic Oncology Group, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Via Maroncelli 40, 47014 Meldola, Italy. 15. Department of Human Pathology, University of Messina and Medical Oncology Unit, Papardo, Via Consolare Valeria 1, 98125 Messina, Italy. 16. UOSD Pneumologia Oncologica, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Roma, Italy. 17. Oncology Unit, ASST San Gerardo Hospital, Via G. B. Pergolesi 33, 20052 Monza, Italy. 18. Oncology Unit, S.G. Moscati Hospital, Via Paisiello 1, 74100 Taranto, Italy. 19. Oncology Unit, Scientific Institute for Research and Health Care (IRCCS) "Casa Sollievo della Sofferenza", Viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy. 20. Department of Oncology, University of Turin, AOU San Luigi, Regione Gonzole 10, 10043 Orbassano, Italy.
Abstract
OBJECTIVES: Molecular profiling of advanced non-small-cell lung cancer (NSCLC) is recommended according to European and Italian guidelines. However, molecular routine assessment remains still heterogeneous. This observational study aimed to take a picture of the real clinical practice in molecular testing and therapeutic choices in advanced Italian NSCLCs. MATERIALS AND METHODS: This study prospectively enrolled newly diagnosed advanced or recurrent NSCLCs referred to 38 Italian centres, from November 2014 to November 2015. Information regarding molecular profiling and treatment choices were collected. Description of patients' outcome included overall survival (OS), progression-free survival in first (PFS1) and second-line (PFS2). RESULTS AND CONCLUSION: Among 1787 patients enrolled, 1388 (78%) performed at least one molecular analysis during the history of disease: 76% were tested for EGFR, 53% for ALK, 27% for KRAS, 16% for ROS1, 14% for BRAF, 5% for HER2, 4% for MET and 1% for FGFR. The remaining 399 patients (22.3%) did not receive any molecular test. Among patients receiving at least one molecular analysis, 583 (42%) presented a molecular alteration. Considering EGFR mutated and/or ALK rearranged patients (402), for which target agents were routinely reimbursed at time of study in Italy, the 86% received a personalized treatment as first and/or second line: the 90% (286) of EGFR mutants received an EGFR tyrosine kinase inhibitor, mostly gefitinib (41.1%) or afatinib (36.4%) while 74% (62) of ALK translocated patients received an ALK inhibitor, mostly crizotinib (64%). Median OS was 9.34 months (95% CI 8.62-10.0), median PFS1 was 4.61 months (95%CI 4.31-4.84) and median PFS2 was 2.76 months (95%CI 2.57-3.19). In the Italian clinical practice, routine molecular assessment was largely applied in NSCLC patients, according to national guidelines, but a low level of ALK test was reached. Most of EGFR mutants an ALK rearranged patients received a personalized treatment as first and/or second line.
OBJECTIVES: Molecular profiling of advanced non-small-cell lung cancer (NSCLC) is recommended according to European and Italian guidelines. However, molecular routine assessment remains still heterogeneous. This observational study aimed to take a picture of the real clinical practice in molecular testing and therapeutic choices in advanced Italian NSCLCs. MATERIALS AND METHODS: This study prospectively enrolled newly diagnosed advanced or recurrent NSCLCs referred to 38 Italian centres, from November 2014 to November 2015. Information regarding molecular profiling and treatment choices were collected. Description of patients' outcome included overall survival (OS), progression-free survival in first (PFS1) and second-line (PFS2). RESULTS AND CONCLUSION: Among 1787 patients enrolled, 1388 (78%) performed at least one molecular analysis during the history of disease: 76% were tested for EGFR, 53% for ALK, 27% for KRAS, 16% for ROS1, 14% for BRAF, 5% for HER2, 4% for MET and 1% for FGFR. The remaining 399 patients (22.3%) did not receive any molecular test. Among patients receiving at least one molecular analysis, 583 (42%) presented a molecular alteration. Considering EGFR mutated and/or ALK rearranged patients (402), for which target agents were routinely reimbursed at time of study in Italy, the 86% received a personalized treatment as first and/or second line: the 90% (286) of EGFR mutants received an EGFR tyrosine kinase inhibitor, mostly gefitinib (41.1%) or afatinib (36.4%) while 74% (62) of ALK translocated patients received an ALK inhibitor, mostly crizotinib (64%). Median OS was 9.34 months (95% CI 8.62-10.0), median PFS1 was 4.61 months (95%CI 4.31-4.84) and median PFS2 was 2.76 months (95%CI 2.57-3.19). In the Italian clinical practice, routine molecular assessment was largely applied in NSCLCpatients, according to national guidelines, but a low level of ALK test was reached. Most of EGFR mutants an ALK rearranged patients received a personalized treatment as first and/or second line.
Authors: Giulia Pasello; Giovanni Vicario; Fable Zustovich; Francesco Oniga; Stefania Gori; Francesco Rosetti; Andrea Bonetti; Adolfo Favaretto; Silvia Toso; Roberta Redelotti; Antonio Santo; Daniele Bernardi; Petros Giovanis; Cristina Oliani; Lorenzo Calvetti; Carlo Gatti; Giovanni Palazzolo; Zora Baretta; Alberto Bortolami; Laura Bonanno; Marco Basso; Jessica Menis; Donatella Da Corte; Stefano Frega; Valentina Guarneri; PierFranco Conte Journal: Oncologist Date: 2019-03-07
Authors: Mariano Provencio; Manuel Cobo; Delvys Rodriguez-Abreu; Virginia Calvo; Enric Carcereny; Alexandra Cantero; Reyes Bernabé; Gretel Benitez; Rafael López Castro; Bartomeu Massutí; Edel Del Barco; Rosario García Campelo; Maria Guirado; Carlos Camps; Ana Laura Ortega; Jose Luis González Larriba; Alfredo Sánchez; Joaquín Casal; M Angeles Sala; Oscar Juan-Vidal; Joaquim Bosch-Barrera; Juana Oramas; Manuel Dómine; Jose Manuel Trigo; Remei Blanco; Julia Calzas; Idoia Morilla; Airam Padilla; Joao Pimentao; Pedro A Sousa; Maria Torrente Journal: BMC Cancer Date: 2022-07-05 Impact factor: 4.638