Author of

• 11794

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  P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11796

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    P2.12-002 - Clinical characteristics and prognosis of lung adenocarcinoma driver mutations from Chinese population (ID 1292)

    09:30 - 09:30  |  Author(s): Y. Li
    • Abstract

    Background
    Driver gene mutation in lung adenocarcinoma varies greatly among different populations, and lacks of large sample study on Chinese population. The purpose of this study was to identify driver gene mutations or translocations, and to evaluate their association with clinicopathological features and prognosis in Chinese lung adenocarcinoma.

    Methods
    Gene mutations or translocations were detected by fluorescence quantitative PCR in tumor tissues of 762 lung adenocarcinoma patients, including mutations of EGFR, KRAS and BRAF, and translocations of ALK and RET. The correlation of gene mutations/translocations with clinicopathological features was retrospectively analyzed by Chi-square test and logistic regression. Kaplan-Meier survival curves were used to evaluate the correlation of these genes with disease-free survival(DFS) in 314 patients and overall survival(OS) in 564 patients respectively.

    Results
    In the 762 patients with lung adenocarcinoma, the positive rate of gene mutations/translocations involving EGFR, KRAS, ALK, RET and BRAF was 49.6%, 10.0%, 4.5%, 1.7%, 0.5%, respectively, among which there was no mutations of polygenes. This study showed that EGFR mutations were more common in non-smokers or light smokers, lepidic predominant invasive adenocarcinoma subtype, and patients without distant metastasis. KRAS mutations were more common in heavy smokers, mucinous invasive adenocarcinoma subtype, and early stage patients. ALK translocations were more common in patients younger than 55 years old, with solid predominant invasive adenocarcinoma subtypes. RET translocations were more common in patients younger than 52 years old, with solid predominant invasive adenocarcinoma subtypes and patients who have family history of lung cancer. BRAF mutations were more common in mucinous invasive adenocarcinoma subtype. The survival analysis showed that the median OS of EGFR-mutant group was shorter than wild-type group among stage IIIB-IV paitents without targeting therapy(P=0.019); Although KRAS gene mutations in patients with early stage was not related to disease recurrence and survival either, KRAS mutations in stage IIIA patients do contribute to shorter DFS and OS(P=0.018, 0.039); ALK translocations in each stage subgroup were not related to recurrence and survival; Patients with mutations of either EGFR, KRAS, or translocations of ALK as a group showed no significant difference in DFS and OS as compared to those without involvement of any of these genes.

    Conclusion
    The overall driver gene positive rate in this series detected by Q-PCR is 66.3%. Each type of drive gene corresponds to different clinical and pathological features. Patients with ALK or RET gene translocations are more younger, and more likely to be solid predominant invasive adenocarcinoma. EGFR-mutant group has shorter OS than wild-type group among stage IIIB-IV paitents without targeting therapy. KRAS mutations implicate poor prognosis only in patients with stage IIIA.