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Published on: February 27, 2020
Elderly male smokers with right lung tumors are viable candidates for KRAS mutation screening
Yang Yang1, Chun Shi2,3, Hui Sun4
1Department of Thoracic Surgery, Shanghai Pulmonary Hospital affiliated Tongji University, Shanghai 200433, China.
Abstract:
Genetic aberrations in tumor driver genes provide specific molecular targets for therapeutic intervention, which can greatly improve therapeutic outcomes. Here, we analyzed the mutational frequency of EGFR and KRAS gene, as well as EML4-ALK rearrangement, and summarized the clinicopathological characters of Chinese lung cancer patients. We detected the mutation spectrum of 1033 primary lung cancer patients. The analyzed clinicopathological parameters included gender, age at diagnosis, smoking status, pathological TNM stage, tumor morphology and location, visceral pleural invasion, and histological type. A total of 618 patients had mutations in EGFR or KRAS gene as well as rearrangement of EML4-ALK. Exon 19 deletions and L858R in the EGFR gene were the most frequent mutations. Left-side lung cancer was more common in female patients carrying the KRAS mutation. Rearrangement of EML4-ALK was more common in non-tobacco-using male patients, who also exhibited a higher likelihood of visceral pleura invasion. Elderly females who never smoked and possessed 1-20 mm stage I adenocarcinomas in the right side exhibited a higher frequency of EGFR mutations. Elderly male smokers with right lung tumors were viable candidates for KRAS mutation screening.
Insights
This study analyzed genetic mutations in Chinese lung cancer patients, finding EGFR and KRAS mutations and EML4-ALK rearrangements. Specific mutations correlated with patient demographics and tumor characteristics, aiding targeted therapy selection.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Genetic aberrations in tumor driver genes like EGFR and KRAS are crucial for targeted lung cancer therapy.
- Understanding the mutation spectrum and clinicopathological correlations is vital for optimizing treatment strategies in diverse patient populations.
Purpose of the Study:
- To analyze the mutational frequency of EGFR, KRAS, and EML4-ALK rearrangements in Chinese lung cancer patients.
- To correlate these genetic alterations with clinicopathological characteristics, including demographics, smoking status, and tumor features.
Main Methods:
- Retrospective analysis of mutation spectrum in 1033 primary lung cancer patients.
- Evaluation of clinicopathological parameters: gender, age, smoking status, TNM stage, tumor location, visceral pleural invasion, and histological type.
Main Results:
- 618 out of 1033 patients (approx. 60%) harbored EGFR/KRAS mutations or EML4-ALK rearrangement.
- EGFR mutations (Exon 19 deletions, L858R) were most frequent.
- KRAS mutations were more common in female patients with left-sided lung cancer.
- EML4-ALK rearrangement occurred more in non-smoking males with visceral pleural invasion.
- EGFR mutations were frequent in elderly, non-smoking females with early-stage right-sided adenocarcinoma.
- KRAS screening is recommended for elderly male smokers with right lung tumors.
Conclusions:
- Specific genetic aberrations in lung cancer are linked to distinct clinicopathological features in the Chinese population.
- Identifying these correlations can guide personalized therapeutic interventions and patient selection for targeted therapies.
- This study provides valuable insights into the molecular landscape of lung cancer in China, supporting precision medicine approaches.
