46P The frequency of driver mutations in non-small cell cancer patients: Analysis of the 5064 patients in the Turkish nation-wide, observational, registurkLung study

The role of driver mutations and PDL-1 status in the treatment of NSCLC is increasing. Biomarker evaluation is performed in almost all of the patients and treatments are applied according to this evaluation. In this study, the frequency and testing rates of biomarkers in patients with NSCLC were investigated. In the "Registurk-Lung" study (NCT05254119) conducted in our country, histopathological, molecular, and clinical data of more than 5865 patients from 42 centers were collected. Biomarkers (EGFR, ALK, ROS-1, BRAF, MET, RET, KRASG12C, PDL-1, Her-2, TP53, and NTRK gene fusions) were evaluated in terms of the rates of testing and detected alteration rates. The median age was 64 (26-97) years and 18,2% of the patients were female. 63,2% of the patients had non-squamous and 36,8% had squamous histology. In this study, data of 1380 non-squamous lung cancer patients were evaluated. We found the test performing rates of biomarkers in these patients as EGFR mutation in 77,1%, ALK rearrangement in 73,3%, ROS-1 in 58,2%, BRAF mutation in 24,7%, MET alteration in 7,5%, RET fusion in 8,3%, KRASG12C mutation in 7,6%, HER-2 mutation in 5,1%, PDL-1 expression in 59,4%, and NTRK gene fusions in 6,1% of the patients. When we examined the alteration rates, EGFR mutation was found as 10,4%, ALK rearrangement 3,2%, ROS-1 1.2%, BRAF mutation 1,7%, MET alteration 1,2%, RET fusion 0,5%, KRASG12C mutation 18,9%, HER-2 mutation 0,4%, TP53 mutation 23,6% and NTRK gene fusions 0,14%. The PDL-1 expression was negative (<1%) in 40,4% of the patients. The rate of patients with PDL-1 expression greater than 50% was 24,0%, while the rate of PDL-1 expression 1-49% was 35,6% of the patients. While single biomarker targeted tests (IHC, PCR, FISH.) were applied as a main method, comprehensive genomic analysis (CGA, NGS) was performed in only 7,8% of the patients. As a result of comprehensive genomic analysis, a druggable result was detected in 14% of the patients. An awareness has been raised about the use of biomarkers in the treatment of lung cancer. This awareness and the identification of biomarkers and directing the treatment will benefit our patients in terms of survival and treatment adherence.