Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts2Cancer Program, Broad Institute of MIT and Harvard, Boston, Massachusetts.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
JAMA Oncol. 2017 Jun 1;3(6):801-809. doi: 10.1001/jamaoncol.2016.6108.
Lung cancer is the leading cause of cancer death in the United States in all ethnic and racial groups. The overall death rate from lung cancer is higher in black patients than in white patients.
To compare the prevalence and types of somatic alterations between lung cancers from black patients and white patients. Differences in mutational frequencies could illuminate differences in prognosis and lead to the reduction of outcome disparities by more precisely targeting patients' treatment.
DESIGN, SETTING, AND PARTICIPANTS: Tumor specimens were collected from Baptist Cancer Center (Memphis, Tennessee) over the course of 9 years (January 2004-December 2012). Genomic analysis by massively parallel sequencing of 504 cancer genes was performed at Dana-Farber Cancer Institute (Boston, Massachusetts). Overall, 509 lung cancer tumors specimens (319 adenocarcinomas; 142 squamous cell carcinomas) were profiled from 245 black patients and 264 white patients.
The frequencies of genomic alterations were compared between tumors from black and white populations.
Overall, 509 lung cancers were collected and analyzed (273 women [129 black patients; 144 white patients] and 236 men [116 black patients; 120 white patients]). Using 313 adenocarcinomas and 138 squamous cell carcinomas with genetically supported ancestry, overall mutational frequencies and copy number changes were not significantly different between black and white populations in either tumor type after correcting for multiple hypothesis testing. Furthermore, specific activating alterations in members of the receptor tyrosine kinase/Ras/Raf pathway including EGFR and KRAS were not significantly different between populations in lung adenocarcinoma.
These results demonstrate that lung cancers from black patients are similar to cancers from white patients with respect to clinically actionable genomic alterations and suggest that clinical trials of targeted therapies could significantly benefit patients in both groups.
肺癌是美国所有族裔和种族中导致癌症死亡的主要原因。黑人患者的肺癌总体死亡率高于白人患者。
比较黑人和白人肺癌患者中体细胞改变的发生率和类型。突变频率的差异可以阐明预后的差异，并通过更精确地针对患者的治疗来减少结果的差异。
设计、地点和参与者：肿瘤标本来自田纳西州孟菲斯的浸礼会癌症中心（Baptist Cancer Center），在 9 年期间（2004 年 1 月至 2012 年 12 月）收集。在马萨诸塞州波士顿的 Dana-Farber 癌症研究所（Dana-Farber Cancer Institute）进行了 504 个癌症基因的大规模平行测序的基因组分析。总体而言，从 245 名黑人患者和 264 名白人患者中对 509 个肺癌肿瘤标本（319 个腺癌；142 个鳞状细胞癌）进行了分析。
比较了黑人肿瘤和白人肿瘤中基因组改变的频率。
共收集和分析了 509 例肺癌（273 例女性[129 名黑人患者；144 名白人患者]和 236 例男性[116 名黑人患者；120 名白人患者]）。使用具有遗传支持的祖先的 313 个腺癌和 138 个鳞状细胞癌，在纠正了多重假设检验后，两种肿瘤类型的黑人和白人人群的总体突变频率和拷贝数变化均无显著差异。此外，在肺腺癌中，受体酪氨酸激酶/Ras/Raf 通路成员（包括 EGFR 和 KRAS）的特定激活改变在人群之间也没有显著差异。
这些结果表明，黑人患者的肺癌与白人患者的肺癌在临床上可采取的基因组改变方面相似，这表明针对这些改变的靶向治疗临床试验将使两个群体的患者都受益。
