Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
Network Genomic Medicine (Lung Cancer), Cologne, Germany.
Clin Cancer Res. 2018 Jul 1;24(13):3087-3096. doi: 10.1158/1078-0432.CCR-17-3416. Epub 2018 Apr 3.
and mutations are associated with impaired prognosis in a variety of cancers and with squamous cell carcinoma formation in non-small cell lung cancer (NSCLC). However, little is known about frequency, histology dependence, molecular and clinical presentation as well as response to systemic treatment in NSCLC. Tumor tissue of 1,391 patients with NSCLC was analyzed using next-generation sequencing (NGS). Clinical and pathologic characteristics, survival, and treatment outcome of patients with or mutations were assessed. mutations occurred with a frequency of 11.3% ( = 157) and mutations with a frequency of 3.5% ( = 49) in NSCLC patients. In the vast majority of patients, both mutations did not occur simultaneously. mutations were found mainly in adenocarcinoma (AD; 72%), while mutations were more common in squamous cell carcinoma (LSCC; 59%). mutations were spread over the whole protein, whereas mutations were clustered in specific hotspot regions. In over 80% of the patients both mutations co-occurred with other cancer-related mutations, among them also targetable aberrations like activating mutations or amplification. Both patient groups showed different patterns of metastases, stage distribution and performance state. No patient with mutation had a response on systemic treatment in first-, second-, or third-line setting. Of -mutated patients, none responded to second- or third-line therapy.- and -mutated NSCLC patients represent a highly heterogeneous patient cohort. Both are associated with different histologies and usually are found together with other cancer-related, partly targetable, genetic aberrations. In addition, both markers seem to be predictive for chemotherapy resistance. .
并且突变与多种癌症的预后不良相关,并与非小细胞肺癌(NSCLC)中的鳞状细胞癌形成相关。然而,对于 NSCLC 中突变的频率、组织学依赖性、分子和临床表现以及对全身治疗的反应知之甚少。使用下一代测序(NGS)对 1391 例 NSCLC 患者的肿瘤组织进行了分析。评估了携带 或 突变的患者的临床和病理特征、生存和治疗结果。在 NSCLC 患者中, 突变的频率为 11.3%(=157), 突变的频率为 3.5%(=49)。在绝大多数患者中,两种突变不会同时发生。 突变主要发生在腺癌(AD;72%),而 突变在鳞状细胞癌(LSCC;59%)中更为常见。 突变分布在整个蛋白质上,而 突变则聚集在特定的热点区域。在超过 80%的患者中,两种突变都与其他癌症相关的突变同时发生,其中还包括可靶向的异常,如激活 突变或 扩增。这两个患者组显示出不同的转移模式、分期分布和表现状态。没有携带 突变的患者在一线、二线或三线治疗中对全身治疗有反应。在 - 突变的患者中,没有一个对二线或三线治疗有反应。 - 和 - 突变的 NSCLC 患者代表了一个高度异质的患者群体。两者都与不同的组织学相关,通常与其他癌症相关的、部分可靶向的遗传异常一起发生。此外,这两种标志物似乎都对化疗耐药有预测作用。