Background: Advanced non-small cell lung cancers (NSCLC) with an oncogenic driver mutation have better outcomes when treated with targeted therapies as opposed to standard therapies. Novel therapies are now making more identified mutations actionable. These driver mutations occur less commonly in squamous cell carcinomas (SCC) and as such, are not necessarily tested in this population. Evidence on the real-world incidence of mutations in this cohort is limited. This study looked at the real-world incidence of driver mutations in advanced NSCLC at a tertiary centre in the first year of pan-histological targeted next generation sequencing (NGS).
Methods: A retrospective observational study design of samples routinely tested with NGS, via an Ampliseq custom 33 gene panel.
Results: 76 patients with advanced NSCLC underwent NGS testing. Adenocarcinoma represented 78.9% and SCC only 7.9% of samples. There were no actionable driver mutations detected in the SCC group. First-line therapy was influenced by NGS in 13.1% of cases and most received osimertinib. TP53 was the most common mutation in the SCC group (83.1%).
Conclusion: The incidence of advanced SCC in our population was lower than expected, although similar to early NSCLC data from another local centre. There were no targetable mutations detected in our SCC cohort. Reductions in smoking rates may be a contributing factor to the low incidence of SCC. Further analysis over a longer time projection would be useful to improve the granularity of this real-world data. NGS remains an important step for consideration towards clinical trials for novel targets.