Aim: One third of the new referrals to thoracic oncology at Monash health are patients from Asian or Sub Continental background. Evaluation of prevalence of EGFR mutated lung cancer is useful to predict recruitment to clinical trials.
Methods: Data extraction from MDT database from October 2015- April 2017. Data analysis based on ethnic background; Caucasian (Australia/UK), Asian (China, Japan, Philippines, Malaysia, Cambodia, Burma), Sub Continental (Sri Lanka, India, Pakistan) or other and analysis EGFR mutation status
Results: We identified 298 new thoracic oncology referrals via MDT, 36 had EGFR mutated lung cancer (19 exon 19, 15 exon 21) and of these 29 were of Asian ethnicity. The median age was 69, 13.8% had smoking history. At diagnosis 16.7 % were stage 1, 11.1 % stage 2, 5.6% stage 3 and 66.7 % stage 4. 22.2 % had brain metastasis at presentation. 88.4 % of eligible patients received first generation TKI.
Conclusion: The prevalence of EGFR mutated lung cancer in the Monash population (12.1%) is relatively higher than what is reported for Australia (7%). Within this population the prevalence of EGFR mutation is also relatively higher at 52.6% than general Asian population (50%). Majority of these patients presented as Stage IV and 22.2% had brain metastasis at presentation. This suggests a correlation between the patient demographics of Monash Health and higher incidence of a subtype of lung cancer most commonly detected in Asian patients. The median duration of response to first generation TKI was 17.8 months which is consistent with published data and at the time of progression all patients were tested for T790M mutation and 72.7% had the mutation present; one patient had transformation to small cell. Certainly these results show that recruitment to clinical trials involving EGFR mutated lung cancer population could be higher at Monash Health.