PT - JOURNAL ARTICLE AU - Josué Pinto AU - Catarina Sousa AU - Natália Martins AU - Sofia Teixeira AU - Adriana Magalhães AU - Gabriela Fernandes AU - Venceslau Hespanhol AU - Henrique Queiroga AU - Hélder Novais E Bastos TI - Mutational status of advanced lung adenocarcinoma in a Portuguese cohort AID - 10.1183/13993003.congress-2019.PA4683 DP - 2019 Sep 28 TA - European Respiratory Journal PG - PA4683 VI - 54 IP - suppl 63 4099 - http://erj.ersjournals.com/content/54/suppl_63/PA4683.short 4100 - http://erj.ersjournals.com/content/54/suppl_63/PA4683.full SO - Eur Respir J2019 Sep 28; 54 AB - Background: Lung cancer treatment paradigm has changed progressively based on tumor biomarkers. Next-generation sequencing (NGS) detects several mutations in oncogenic drivers, thus predicting the response to targeted therapies. This study aimed to understand the impact of mutational status in advanced lung adenocarcinoma (ADC) presentation and prognosis.Methods: A retrospective analysis of detected mutations and their clinical correlations was performed in patients with stage III-IV lung ADC, who performed a molecular study with NGS.Results: A total of 127 patients were studied (mean age 67.6±10.8 years, 63% male, 33.9% non-smokers, 82.6% stage IV). An oncogenic mutation was present in 63.1% of patients, most commonly KRAS mutation (27.6%), followed by EGFR mutation (14.2%) and ALK rearrangement (6.3%). KRAS mutation was mostly found in males (80%) and ex-smokers (48.6%), while EGFR mutation in females (77.8%) and non-smokers (61.1%), with p<0.001 and p=0.002, respectively. No differences were stated between groups with regards to age (p=0.966) and PD-L1 expression (p=0.424). Overall survival was shorter in KRAS-mutated patients, when compared to ALK and EGFR groups (7.1; 7.5; 10.4 months, p=0.231), while progression-free survival was shorter in ALK rearrangement, although submitted to targeted therapy in most cases (71.4%), when compared to KRAS and EGFR mutations (2.8; 3.6; 5.9 months, p=0.323).Conclusions: Molecular characterization plays a key role in stratifying patients that will benefit from targeted therapy, but also provides prognostic information that could support future clinical strategies for lung ADC patients.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4683.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).