(P 366) SURVIVAL DISPARITIES IN HISPANIC PATIENTS WITH SARCOMA TESTED WITH NEXT-GENERATION SEQUENCING (NGS)

Objective: The objective of this study is to investigate whether there are survival disparities among Hispanic patients with sarcoma with next-generation sequencing (NGS) results, treated at a single institution. A prior study from our group in 2019 identified potential disparities in targetable mutations identified by NGS, which led to additional data collection on outcomes and with increased patient numbers. Given the unique demographics of our catchment area in South Florida, our large cohort of Hispanic patients allows us to perform more robust analyses and stratify by additional factors such as grade, stage, and histologic sarcoma subtype.

Methods: A retrospective analysis was performed on 541 patients with both non-GIST soft tissue and bone sarcoma with pathogenic variants found by NGS. We pooled 28,380 patient candidate medical record numbers using ICD10 codes, provider encounters, and past research projects, and queried our proprietary, institutional database, cancerSCOUT, for the pathogenic variants in NGS results from Caris, FoundationOne, and NeoGenomics. We obtained 1,433 unique NGS reports, ultimately yielding 589 sarcoma NGS reports with pathogenic variants belonging to 541 patients after excluding non-sarcoma and GIST diagnoses. We systematically reviewed the clinical data available in the electronic health records to collect information related to diagnosis, survival, and treatment. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards models. Demographic, clinical variables, and genetic alterations identified through NGS were assessed for their association with survival disparities in patients with sarcoma. Mutations were assigned as targetable based on the oncoKB version 4.5 with levels 1 to 4.

Results: Preliminary analysis of the collected data revealed significant survival disparities among Hispanic patients with pathogenic variants within NGS results. Hispanic patients who were non-metastatic at diagnosis had a statistically significantly worse median overall survival (mOS) of 59.9 months vs 114.3 months (p=0.017) compared to non-Hispanic patients. There were no significant differences in survival by ethnicity in this group of patients. Among the entire cohort, both with metastatic and localized disease, Hispanic patients were more likely to have targetable mutations via oncoKB levels 1 to 4. Interestingly, Hispanic patients were more likely to have targetable mutations at 66.5% compared to non-Hispanic patients at 52.6% (p = 0.012). The mutations that varied by ethnicity were as follows: TP53 54% of Hispanic NGS results vs 46.3% of Non-Hispanic NGS results; CDKN2A 12.4% of Hispanic NGS results vs 8.1% of Non-Hispanic NGS results; and PTEN 7.1% of Hispanic NGS results vs 3.0% of Non-Hispanic NGS results. Additional data is being analyzed to determine if differences in NGS results or with subsequent targeted treatment account for any of the noted survival differences. These additional analyses will be presented at CTOS.

Conclusion: These findings highlight the importance of considering both genetic and non-genetic factors in understanding and addressing survival disparities in Hispanic sarcoma patients. Our study reveals the survival disparities observed among Hispanic sarcoma patients with pathogenic NGS results. The integration of genetic information obtained through NGS with clinical and demographic variables allows for a more comprehensive understanding of the factors influencing patient outcomes. Further investigation is warranted to validate and expand upon these initial findings, with the goal of improving survival outcomes and reducing disparities in this patient population.