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Updated: May 6, 2026
Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Bridging East and West: Real-World Clinicogenomic Landscape of Metastatic NSCLC in Türkiye
Kübra Canaslan1, Emre Eken2, Mehmet Bilici2
1Department of Medical Oncology, Dokuz Eylul University, Izmir 35330, Türkiye.
Background/Objectives:
Genomic profiling guides treatment in metastatic non-small-cell lung cancer (mNSCLC), yet country-level data from Türkiye remain limited.
Methods:
We retrospectively analyzed consecutive patients with mNSCLC diagnosed between January 2018 and March 2025 across tertiary centers in all seven regions. Variables included demographics, smoking, histology, testing modality (single-gene vs. next-generation sequencing [NGS]), targetable genomic alterations (TGAs) and co-mutations, and programmed death-ligand 1 (PD-L1) tumor proportion score.
Results:
Among 1023 patients (mean age 64 years; 76.4% male), tobacco exposure was frequent (mean 42.1 pack-years); 16.9% were never-smokers. NGS use increased over time, exceeding 90% by 2025. TGAs were detected in 28.3% (EGFR 16.0%, ALK 5.0%, KRAS G12C 2.6%, BRAF V600E 3.2%; ROS1, MET exon 14, HER2, NTRK ≤ 2.5%; no RET). EGFR alterations occurred in 19% of non-squamous carcinomas and 6% of squamous cell carcinomas (SCCs), suggesting an intermediate East-West pattern. Among NGS-tested samples, TP53 was the most frequent co-mutation (33.1%), followed by alterations in CDKN2A, PIK3CA, FGFR, STK11, and KEAP1.
Conclusions:
In this large, multicenter Turkish real-world cohort, the TGA spectrum broadly mirrors global patterns while revealing local nuances; EGFR mutations were more frequent than expected in SCC, and nationwide NGS adoption is accelerating. Limitations include retrospective design, non-centralized PD-L1 testing, and missing data. Prospective, standardized studies integrating outcomes and resistance mechanisms are warranted to refine regional precision oncology.
Insights
Genomic profiling in metastatic non-small-cell lung cancer (mNSCLC) shows global patterns with Turkish nuances, including accelerated next-generation sequencing (NGS) adoption. EGFR mutations were more frequent in squamous cell carcinomas than expected.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- Genomic profiling is crucial for guiding treatment in metastatic non-small-cell lung cancer (mNSCLC).
- Limited country-level data exists for Türkiye regarding genomic alterations in mNSCLC.
Purpose of the Study:
- To analyze the genomic landscape of mNSCLC in Türkiye.
- To assess the adoption and impact of next-generation sequencing (NGS) in Turkish mNSCLC patients.
Main Methods:
- Retrospective analysis of 1023 mNSCLC patients across Turkish tertiary centers (2018-2025).
- Evaluation of demographics, smoking history, histology, testing modality (NGS vs. single-gene), targetable genomic alterations (TGAs), co-mutations, and PD-L1 status.
Main Results:
- TGAs found in 28.3% of patients; EGFR (16.0%), ALK (5.0%), KRAS G12C (2.6%), BRAF V600E (3.2%).
- NGS use exceeded 90% by 2025; TP53 was the most frequent co-mutation (33.1%).
- EGFR alterations were more common in squamous cell carcinomas (6%) than anticipated.
Conclusions:
- The TGA spectrum in Türkiye aligns with global trends but shows regional specificities.
- Nationwide adoption of NGS for mNSCLC is rapidly increasing.
- Further prospective studies are needed to integrate outcomes and resistance mechanisms for refined precision oncology.
