Mutational landscape of lung adenocarcinoma in Czechia

Limited DNA sequencing data on lung cancer (LC) patients are available from Eastern Europe where male smoking is commonest in Europe. As sequence analysis is the prerequisite for targeted therapy we provide such data from Czechia (CZ). Additionally, we present novel sequencing data for adenocarcinoma subtypes. Panel sequencing data on 1218 adenocarcinoma patients were available from a single histology laboratory for 2016 to 2024. The highest variant frequencies were observed for KRAS (51.6%), EGFR (18.8%) and TP53 (16.3%). Commonest types of variants were codon 12 mutations for KRAS, exon 21 L858R for EGFR and V600E BRAF. EGFR variants were more common in females (25.3% vs 11.5%). KRAS mutations were frequent in males (56.9% vs 46.9%), as were PIK3CA mutations (3.8% vs 1.9%). KRAS mutations were frequent in patients diagnosed below 70 years, whereas EGFR, PIK3CA and MET alterations were frequent in patients above age 70 years. As stage distinctions, high prevalence of KRAS mutations was found in early stage tumors (II and IIIA) and of TP53 mutations in stages IIIB and IV. As to adenocarcinoma subtypes, lepidic type showed a high frequency of EGFR variants. We could show differential distribution of gene variants by sex, diagnostic age, stage and subtype of adenocarcinoma. The data are in line with current literature that targeted treatment is being applied for selected LC patients in CZ. It can be expected that LC patients benefit from therapeutic and other clinical improvements, which however do not reduce the primary importance of anti-smoking campaigns.