e16067 Background: The clinical and mutational profile of Hispanic patients with metastatic colon cancer is not well documented. In this retrospective study, we aim to describe the clinical and mutational profile of Hispanic patients with metastatic colon cancer in central California. Methods: We retrospectively evaluated the clinical and mutational profile of colon cancer at a single institution in Fresno, California from 2010-2019. We selected 136 patients out of which 70 patients self-identified as Hispanic and 66 self-identified as non-Hispanic. We studied clinical parameters and next-generation sequencing via Foundation one testing for these patients. Results: Among Hispanics, there were 43(61%) males and 27(38%) females. The median age at diagnosis was similar in both groups at 57. Right sided colon cancer accounted for 52% of Hispanic patients versus 40% in non-Hispanics. Fifty two percent of Hispanic patients presented with metastatic disease versus 45% in non-Hispanics. The frequency of commonly mutated genes in colon cancer in Hispanics versus non-Hispanics are as follows. KRAS (35.7% vs 37%), NRAS (11% vs 4%) BRAF (8% vs 7%), Her2/neu 0% in both groups. The frequency of other mutations such as TP53, APC, ATM, PTEN, CDKN2A, Myc amplification were also noted to be similar in both groups. PIK3CA mutation was seen in 18.6% of Hispanic patients versus 34% in non-Hispanic population which was statistically significant with a p value = 0.032. Microsatellite instability (MSI) was seen at 3.3% in Hispanics versus 10.6% in non-Hispanics. Tumor mutational burden was similar in both groups. Conclusions: The frequency of actionable mutations was similar in both Hispanic and non-Hispanic patients. Hispanics were noted to have lower PIK3CA and microsatellite instability. Metastatic disease and right sided colon cancer were seen at higher frequency in Hispanic population. Our results were similar to another population-based study which analyzed KRAS mutation with colon cancer patients in Puerto Rico[1]. Larger population based studies would be needed to further assess the differences in this patient population. Ruiz-Candelaria, Y., C. Miranda-Diaz, and R.F. Hunter-Mellado, K-RAS mutation profile in Puerto Rican patients with colorectal cancer: trends from April 2009 to January 2011. Int J Biol Markers, 2013. 28(4): p. e393-7.
7535 Background: Primary central nervous system lymphoma (PCNSL) is a rare type of non-Hodgkin lymphoma, distinguished by poor prognosis. Previous studies have identified MYD88, CD79b and PIM1 as the most common genetic mutations in PCNSL. However, the extent to which mutations vary by ethnicity is unknown. The purpose of this study was to describe differences in genetic mutations and survival by Hispanic ethnicity in PCNSL. Methods: We retrospectively reviewed records of 30 patients with PCNSL diagnosed between January 2007- December 2017. We examined mutations in 275 genes by DNA analysis and 1382 genes by RNA analysis utilizing next generation sequencing. Results: Among the thirty patients, median age was 60 years, 60% were male, and 60% were Hispanic. Twenty-four patients had activated B-cell (ABC) and 5 patients had germinal center (GC) type per Hans criteria. Among 29 patients with complete mutation data, 125 different mutated genes were detected. Missense mutations were the most common (75%) followed by frame shift mutations (25%). The most commonly affected genes were: MYD88 (44%), CARD11 (21%), CD79b (17%), PIM1 (17%), KMT2D (17%) and ETV6 (14%). CD79b mutation was more common in GC type vs. ABC type (60% vs. 8%, P=.01). MYD88 mutation was less frequent in Hispanic patients (27% vs 66%, P=.02), while there were no statistically significant differences in CARD11 (22% vs 18%, P=.79), KMT2D (22% vs 9%, P=.36), CD79B (16% vs 19%, P=.92) and PIM1 (16% vs 19%, P=.92). There were more Hispanic patients with >3 mutated genes (89% vs 55 %. P=.03). Two-year progression-free survival (PFS) and overall survival (OS) were 46% and 50%, respectively. Both outcomes were superior among Hispanic vs. non-Hispanic patients (2-yr PFS 60% vs 27%, P=.09), (2-yr OS 60% vs 36%, P=.23), but this was not statistically significant. MYD88, CARD11, PIM1, and KMT2D were not associated with significant differences in 2-year OS or PFS. However, patients with CD79b mutations had superior 2-yr PFS (P=.04). Conclusions: We identified highly recurrent genetic alterations in PCNSL. Our data suggest that some heterogeneity in the most frequent mutations in PCNSL may be related to ethnicity. However, the superiority in 2-yr PFS and OS did not reach statistical significance in our Hispanic patients. Further studies on a larger patient population may further help to describe the differences in incidence, tumor biology, and outcomes in Hispanic patients.
e20551 Background: Extramedullary Plasmacytoma (EMP) occurs when neoplastic plasma cells cross the bone cortex to the surrounding soft tissue or spread hematogenously to other organs. The incidence rate of isolated plasmacytoma is reported to be 2-5% of plasma cell neoplasm. The skeletal system, head and neck are common organs involved. Our study evaluates the clinicopathologic characteristics of patients with EMP, with or without multiple myeloma (MM) in Central Valley, California. Methods: This is a retrospective review of 354 patients diagnosed with plasma cell dyscrasias, from January 2000 to January 2018. 33 patients had pathologically confirmed EMP and were evaluated for clinicopathologic data. Results: The incidence rate of EMP during the study period was 9%. Of the 33 patients diagnosed with EMP, 26 (78%) were associated with MM. The mean age at diagnosis was 62.6 years with no significant difference in mean age at diagnosis between patients with isolated EMP and EMP with MM (p = 0.23). Of the 33 patients, 11 (36.7%) were Hispanic, 11 (36.7%) were Caucasian whilst the rest constitute other minorities. This mirrored the 2010 population profile of the county. There are no statistically significant ethnic differences in the incidence of EMP with OR of 1.96 (p = 0.84). Compared to isolated EMP where aerodigestive system is most common site, bone with soft tissue (21%) is the most frequent site of involvement in EMP with MM [Table]. 9 (37%) patients were found to have IgG kappa as most common serum immunofixation finding in EMP with MM. FISH displayed high risk cytogenetics in 11 (45%) patients in the group. 91% of patients with EMP and MM were treated with chemotherapy alone or in combination with surgery or radiation. The median overall survival of patients with isolated EMP and EMP with MM was 46 months [95% CI: 11.2-80.9] and 55 months [95% CI: 16.3-93.7] respectively. Conclusions: The number of patients with isolated EMP is small for comparison with patients with EMP and MM. EMP occurs frequently with MM either at diagnosis or with disease progression. It tends to have high risk cytogenetics and may signify more aggressive disease. [Table: see text]
7524 Background: Philadelphia-like Acute B-ALL(PHL) are Ph negative B-ALL(PHN) with molecular signatures that mirrors Ph + B ALL. Studies have shown worse prognosis in this subtype of leukemias, but few have reported outcomes with incorporation of novel agents. Our study seeks to describe clinical and molecular profile of a single center experience. Methods: This is a retrospective study of patients treated for PHL in community referral center in central valley of California from 1/2009 to 12/2019. Of the initial 71 patients, 34 met the inclusion and exclusion criteria. 16 of the 34 patients who had Next Generation Sequencing (NGS) by Foundation Medicine (14) or NeoGenomics (2). Data for 34 PHN and 8 with PHL patients were analyzed. Results: There are no differences in mean ages (36.7 x 36) and gender between the PHN and PHL subgroup. There is over representation of Hispanics in both groups (63% x 65%) with slightly male predominance in PHL group (62%). This ratio is slightly higher than reported by 2010 census of 46%. The BMI 38.4(27.5-48.4) vs. 29.1(26.6-39.1), mean WBC (71 vs. 58), bone marrow CD20+ by flow cytometry (90% vs. 63%) and abnormal cytogenetics (50% vs.15%) are all higher in PHL compared to PHN group. The prevalence rate of PHL signature in 16 tested patients is 8(50%). CRLF2 like subtype accounted for 6/8(75%), with 1 each of ABL-like and JAK-Stat subtype. All patients harbored multiple other mutational abnormalities in addition to those associated with Ph-like genetic signatures (Table). The median number of mutations was 4.55(3-7). The distribution of the 20 other mutation is as shown in table. 6 patients had morphological remission after induction chemotherapy of HyperCVAD (37%) and CALGB 10403 (25%) with measurable MRD in 5 of the patients. 7 patients were exposed to novel therapy; Blinatumomab; 2nd line (6 patients), Cart T cell; 3rd line (2 patients), Inotuzumab; 3rd line (3 patients) and ASCT; (3 Patients post second- or third-line remission). 2 patients died at the time of data cut off, 1 from infection and other from refractory leukemia. Conclusions: Our data shows high incidence of PHL signatures in the cohort. The mutational heterogeneity between and within patients, may represent sub-clonal population vs. passenger and hence poor clinical outcomes. [Table: see text]
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