1056P KRAS and LKB1 mutation conferring prognostic and predictive role on liquid biopsy in advanced NSCLC

Liquid biopsy (LB) is a feasible tool able to detect genomic alterations in cancer at baseline and also as longitudinal monitoring identify resistance mutations. In patients (pts) with mNSCLC, when tissue remains difficult procedure, LB might be crucial for therapeutical options, especially the immunotherapy (IO) target therapy era. The aim of this bicentric study assess prognostic value mNSCLC. Data from mNSCLC any gene alteration/PD-L1 expression were collected Istituto Nazionale Tumori Milan Policlinico Universitario Naples. was performed by 73-gene Guardant360® CDx / 29-gene Archer® LiquidPlex™panels. Effects circulating on Overall Survival (OS) (from 4-stage diagnosis death/last FUP) assessed using Cox proportional hazard model cell free. Kaplan-Meier curves OS between IO non-IO treatments arms. Of 488 pts underwent LB, most male (56.9%), former smoker (46.3%), adenocarcinoma (73.6%) PD-L1 > 1% (55.6%). 301/488 (62.6%) treated alone or combination chemotherapy, first (47.0%) second line (102 – 29.2%). 133 (32.1%) cases, baseline, while 101 (24.5%) cases progression. Among relevant genes, STK11+/LKB1+ confers worst (HR 2.12 months, CI 95% 1.26 3.56; p = 0.005), regardless treatments. LKB1+/KRAS+ have poorer than LKB1-/KRAS- (OS: 13 vs 24 m, HR 2.34 IC 1.19 4.61) LKB1-/KRAS+ 34 m 2.99 1.36-6.54). When analyzing effect KRAS arms, KRAS-/IO best prognosis compared KRAS+/non-IO which prognosis, KRAS+/IO seems similar KRAS-/non-IO 0.82 0.43 1.58). Results reported confirmed previous reports tissue: STK11+ pts, KRAS+ compare STK11+/KRAS+ STK11-/KRAS- prognosis. play role survival status, fact negative decreases becomes pts.