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Background The aim of this study was to carry out a descriptive analysis of the somatic genetic profile and co‐occurring mutations of non‐small cell lung cancer (NSCLC) samples from patients tested with comprehensive genomic profiling (CGP). Methods This was a retrospective cross‐sectional study of patients diagnosed with NSCLC from 2013 to 2018 in Brazil and whose samples were submitted to CGP (FoundationOne or FoundationACT) using either tumor or circulating tumor DNA (ctDNA) from plasma. Results We recovered 513 CGP results from patients, 457 (89.1%) of which were from tumors and 56 (10.9%) from plasma. The median age of patients was 64 years old, of which 51.6% were males. TP53 mutations were identified in 53.6% of tumor samples, KRAS mutations in 24.2%, EGFR activating mutations were detected in 22.5%, STK11 mutations in 11.6%, PIK3CA mutations in 8.8%, ALK rearrangements in 5.4%, BRAF mutations in 5.2%, and ERBB2 alterations in 4.9%. The most commonly comutated gene was TP53. TP53 p.R337H was observed in 4.3% of samples and was associated with somatic mutations in EGFR and ERBB2 (P, This is the first report of the prevalence of driver mutations in Brazilian NSCLC patients using comprehensive genomic profiling.

BACKGROUND Healthy lifestyle has been shown to have a positive impact on quality of life, risk of recurrence, and overall survival in breast cancer (BC). Physicians play an important role in encouraging their patients to lifestyle modification. Nonetheless, little is known whether physician lifestyle can impact on healthy habits recommendations to BC patients. We aimed to evaluate how physician’s lifestyle influences the prescription of healthy habits to BC patients. METHODSLACOG 1218 was an observational, cross-sectional study. An online questionnaire composed of 14 objective questions to evaluate physician lifestyle and prescription of healthy habits to BC patients was developed and circulated by e-mail to breast surgeons, clinical and radiation oncologists who were members of the Brazilian Society of Clinical Oncology (SBOC) and Latin American Cooperative Oncology Group (LACOG) and dedicated to the treatment of BC patients. The primary objective of the study was to evaluate the correlation between the physician lifestyle and the prescription of healthy habits to BC patients. A multivariate Poisson regression analysis was used to assess which factors of physician lifestyle could influence prescription of healthy habits.RESULTSA total of 267 physicians answered the questionnaire from October to November 2018. Of these, 142 (53.2%) were clinical oncologists, 116 (43.5%) were breast surgeons, and 9 (3.4%) were radiation oncologists. Female were 58.4%, 51.8% were older than 50 years and the majority 71.5% worked in private health insurance practice. In terms of physician lifestyle, 228 (85.4%) had healthy eating habits, 236 (88.4%) practiced physical activity and 93 (34.9%) were self-reported with overweight or obese. A total of 143 (46.1%) did not drink alcohol or drunk less than once a month and did not consume more than 5 doses and only 8 (3%) of them were current smoker. Overall, 84.3% of the physicians advised their BC patients on the importance of lifestyle modification. Physicians who did not exercise regularly have a higher chance of not advising for health lifestyle (HR 2.48; 95% CI 1.28 to 4.82, p=0.0265) as opposite to physicians older than 50 years (RR 0.37; CI 95% 0.15 - 0.92; p=0.0118).Obesity treatment and management was performed by 121 (45.3%) of physicians. Being a breast surgeon (RR 1.29; 95% CI 1.02 to 1.63, p=0.0025) or radiation oncologists (RR 1.82; 95% CI 1.43 to 2.31, p=0.0025) were the only factors associated with not performing obesity treatment and management. About 53.4% of physicians referred overweight or obese patients to a dietician and/or endocrinologist. Male gender (RR 1.35; CI 95% 1.03-1.76; p=0.0296), breast surgeons (RR 1.99; CI 95% 1.50-2.64; p=0.0001) and clinical practice in public health system (RR 1.53; CI 95% 1.20-1.96; p=0.0012) were factors associated with not referring patients to dietician and/or endocrinologist as opposed to physicians older than 50 years (RR 0.46; CI 95% 0.28-0.75; p=0.0005).CONCLUSIONIn general physicians treating BC patients have a healthy lifestyle. Physicians who practice physical activity regularly or older than 50 years had more chance to advise lifestyle modification. Only half of BC patients’ physicians treat obesity or refer these patients to specialist which in this case may impact BC patient’s outcome. Citation Format: Renata Cangussú, Eldsamira Mascarenhas, Taiane F Rebelatto, Paulo R Nunes, Rafaela G de Jesus, Facundo Zaffaroni, Gustavo Werutsky. Influence of physician’s lifestyle on the prescription of healthy habits to breast cancer patients (LACOG 1218) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-91.

Introduction We analyzed the prevalence of non–small-cell lung cancer (NSCLC) with a programmed cell death ligand 1 (PD-L1) tumor proportion score (TPS) of ≥ 50% and compared the results with the existing data from clinical trials and databases from other countries. Materials and Methods The Latin American Cooperative Oncology Group and Grupo Brasileiro de Oncologia Toracica performed a retrospective, cross-sectional study from August 2017 to April 2018. PD-L1 expression was collected from pathology reports from 5 laboratories in Brazil. All tests were sponsored by the pharmaceutical industry on request from the treating medical oncologist. PD-L1 expression was assessed by immunohistochemistry. The variables were summarized as absolute and relative frequencies or the median and interquartile range. Pearson's χ2 test was used to compare the TPS categories stratified by sex, age, and histologic type. All analyses were performed with SAS, version 9.4, and were deemed statistically significant at P Results A total of 1512 patients were included in the present study. Their median age was 66 years. Most patients were men (56.02%), and the most common histologic type was adenocarcinoma (58.04%); 109 tumors (11.31%) had EGFR mutations and 34 (3.64%) had ALK gene rearrangements. Overall, 56.54% had a PD-L1 TPS Conclusion The prevalence of high PD-L1 expression among the Brazilian NSCLC samples was lower than previously described in other countries, which could affect the number of patients who might be candidates for immunotherapy alone.

Lung cancer is one of the most incident types of cancer and a leading cause of cancer mortality in Brazil. We reviewed the current status of lung cancer by searching relevant data on prevention, diagnosis, and treatment in the country. This review highlights several issues that need to be addressed, including smoking control, patient lack of awareness, late diagnosis, and disparities in the access to cancer health care facilities in Brazil. We propose strategies to help overcome these limitations and challenge health care providers, as well as the society and governmental representatives, to work together and to take a step forward in fighting lung cancer.

New cases of the novel coronavirus disease 2019 (COVID-19), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continue to rise worldwide following the declaration of a pandemic by the World Health Organization (WHO). The current pandemic has completely altered the workflow of health services worldwide. However, even during this critical period, patients with other diseases, like cancer, need to be properly treated. A few reports have shown that mortality due to SARS-CoV-2 is higher in elderly patients and those with other active comorbidities, including cancer. Patients with lung cancer are at risk of pulmonary complications from COVID-19, and as such, the risk/benefit ratio of local and systemic anticancer treatment has to be considered. For each patient, several factors, including age, comorbidities, and immunosuppression, as well as the number of hospital visits for treatment, can influence this risk. The number of cases is rising exponentially in Brazil, and it is important to consider the local characteristics when approaching the pandemic. In this regard, the Brazilian Thoracic Oncology Group has developed recommendations to guide decisions in lung cancer treatment during the SARS-CoV-2 pandemic. Due to the scarcity of relevant data, discussions based on disease stage, evaluation of surgical treatment, radiotherapy techniques, systemic therapy, follow-up, and supportive care were carried out, and specific suggestions issued. All recommendations seek to reduce contagion risk by decreasing the number of medical visits and hospitalization, and in the case of immunosuppression, by adapting treatment schemes when possible. This statement should be adjusted according to the reality of each service, and can be revised as new data become available.

e18001Background: The use of oral cancer medicines is rising. In Brazil, after coverage was mandated in January 2014, oral cancer medications can be dispensed in the clinic where a patient is treat...