Radiogenomics in 332 metastatic non-small cell lung cancer (NSCLC) patients.

11563 Background: Radiogenomics is focused on defining the relationship between image and molecular phenotypes. Therefore, we assess the association between metastatic sites at baseline CT and molecular abnormalities (MA) in NSCLC patients (pts). Methods: One senior radiologist reviewed retrospective basal CT scans of metastatic NSCLC pts from Gustave Roussy included in the MSN cohort. Tissue biopsy samples of these pts were collected for detecting the molecular profile by NGS platform (Ion-torrent) and/or Sanger sequencing molecular test as daily clinical practice. Radiological characteristics regarding metastatic sites were correlated with the molecular profile. Results: From 06/2009 to 06/2015, 332 metastatic NSCLC pts treated with first-line platinum-based chemotherapy were included (median age 59 years, 63% males, 14% never smokers, 76% adenocarcinoma, 11% with squamous cell carcinoma). Number of metastatic sites by patient was: one for 49%, 2 for 28%, 3 for 14%, > 4 for 9%. After 32.4 months of median follow-up, the median overall survival was of 15.3 months (95%CI: 12.9-17.8). Overall, 60% of NSCLC pts had a MA: 28% KRAS mutation, 14% EGFR mutation, 6% ALK rearrangement, 5% MET amplification or mutation, and 7% other mutations (BRAF and PI3K mutation, and HER2 mutation or amplification). Among pts with KRAS (n = 93), EGFR (n = 47), ALK (n = 21) and MET(n = 16) abnormalities, the respective percentages of brain, adrenal, metastatic pleural effusion, bone and lung metastases were: 39%/28%/18%/40%/33%; 45%/6%/36%/47%/49%; 52%14%/19%/43%/48%; and 44%/25%/0%/44%/25%. Among the 12 pts with peritoneal carcinomatosis, 5 had a mutation (3 with KRAS, 1 NRAS and 1 BRAF). Conclusions: Bone is the most common site of metastases in NSCLC pts. Baseline metastatic sites in molecular selected NSCLC pts are different according to the molecular abnormality. Among KRAS mutant tumours there are a higher percentage of adrenal metastases and a trend toward association with peritoneal carcinomatosis, whereas among ALK tumors exists higher percentage of brain metastases than pleural effusion. MET tumors have a tropism for the brain similar to the other molecular abnormalities, whereas lung metastases are especially frequent in EGFR and ALK tumours.