PurposeDiscoveries of oncogenic driver alterations in non–small-cell lung
cancer (NSCLC) have been accompanied by the development of effective
targeted therapies. The frequencies of these mutations vary between
populations but are less well characterized in the Vietnamese population. In
this study, we analyzed the frequencies of lung cancer driver oncogenic
alterations in Vietnamese patients compared with Vietnamese patients treated
in the United States.MethodsWe collected data on tumor and disease characteristics of Vietnamese patients
with NSCLC treated at Stanford. In addition, we collected NSCLC tumor
specimens from patients with NSCLC diagnosed in Hue, Vietnam, and performed
next-generation–based genotyping on these samples. The molecular and
clinical characteristics of these groups were compared.ResultsFifty-nine Vietnamese patients were identified at Stanford. Of the 44
patients with molecular testing results, there were 21 (47.7%) with
EGFR alterations, six (13.6%) with ALK
alterations, two (4.5%) with KRAS alterations, one (2.3%)
with BRAF alterations, and no ROS1 or
RET alterations. Across all stages, the median overall
survival for patients with a tumor having a targetable genomic alteration
driver mutation was 42.4 months, compared with 27.1 months for patients
without such alterations. In the 45 genotyped samples from Vietnam, there
were 26 (57.8%) with EGFR, 11 (24.4%) with
KRAS, and one each (2.2%) with ALK,
ROS1, and RET.ConclusionThe majority of tumors from both Stanford and Vietnam had targetable
oncogenic alterations. This suggests that routine implementation of
molecular testing may have a significant, positive impact on the treatment
of Vietnamese patients with NSCLC, but affordability of testing and
treatments remains a barrier to adoption.
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