1402P Real-world Routine KRAS Testing Practices in France for Patients (pts) with Advanced or Metastatic (AM) Non-Small Cell Lung Cancer (NSCLC): Data from the ESME Cohort

Sotorasib is available in France since 2019 in clinical trials and now early access program for KRAS G12C AM NSCLC pts who progressed after ≥1 treatment line. KRAS testing is recommended at metastatic stage for all non-squamous (nsq) and non-smokers squamous (sq) NSCLC. Our aim is to understand routine KRAS testing practices for AM NSCLC pts. We performed a retrospective observational cohort study of AM NSCLC patients included in the Epidemio-Strategy and Medical Economics (ESME) Lung Cancer Database from 07/2015 to 10/2021. Pts were split in 4 subgroups: KRAS not tested; KRAS tested at any time of the disease; KRAS tested before first-line treatment (L1); KRAS tested after L1 and before L2. We analyzed 2 periods: 2015-2018 and 2019-2021, according to the date of AM diagnosis. 20 181 AM NSCLC pts were included. 48.1% were tested for KRAS at any time of the disease, without evolution between 2015-2018 and 2019-2021 (48.7% and 43.5%, respectively). Among KRAS tested pts (n=9714), 74.1% were tested before L1 and 23% after L1 / before L2. KRAS and KRAS G12C were positive for 37.8% and 14.7% of pts respectively. KRAS positive pts (n=3668) were tested on tumor (72.1%), metastasis (26.6%) and blood (3%). We described the main differences in pts characteristics overall as no difference was observed between pts tested for KRAS before L1 and after L1 / before L2Table: 1402PKRAS tested at any time (N=9714)KRAS not tested (N=10467)Male %60.571.3ECOG at AM diagnosis 1 % 0-1 ≥269.4 30.657.1 42.9Histology at initial diagnosis % Nsq Sq95.4 4.661.6 38.4Stage at initial diagnosis 2 % Early Locally advanced Metastatic19 9 70.125.8 13.1 58.4L1 received %86.175.7EGFR testing %93.920PDL1 testing %46.537.5For nsq pts Smoking status3 % Non-smoker Former smoker Smoker Median number of pack-years Smoker 4 Former smoker 5N=9271 13.9 50.7 35.5 40 35N=6452 12.2 52.7 35.1 40 40Pts without data in KRAS tested and KRAS not tested cohorts respectively (1) 7 835 ; 8 485 (2) 186;286 (3) 368;445 (4) 405;387 (5) 609;500 Open table in a new tab . Pts without data in KRAS tested and KRAS not tested cohorts respectively (1) 7 835 ; 8 485 (2) 186;286 (3) 368;445 (4) 405;387 (5) 609;500 Approximately half of AM NSCLC pts were not tested for KRAS, without evolution between 2015-2018 and 2019-2021.The emergence of KRAS G12C inhibitors should lead to an increase in AM NSCLC pts testing according to guidelines.