BACKGROUND
The discovery of oncogenic drivers has ushered in a new era for lung cancer, but the role of these mutations in different racial/ethnic minorities is understudied. The Lung Cancer Mutation Consortium 1 (LCMC1) database was investigated to evaluate the frequency and impact of oncogenic drivers in lung adenocarcinomas in the racial/ethnic minority patient population.
PATIENTS AND METHODS
Patients with metastatic lung adenocarcinomas from 14 United States sites enrolled in the LCMC1. Tumor samples were collected from 2009 through 2012, with multiplex genotyping performed on 10 oncogenic drivers (KRAS, EGFR, ALK rearrangements, ERBB2 (formerly HER2), BRAF, PIK3CA, MET amplification, NRAS, MEK1, AKT1). Patients were classified as Caucasian, Asian, African-American (AA), and Latino. Driver mutation frequency, treatments, and survival from diagnosis were determined.
RESULTS
1007 patients were included. Caucasians represented the majority with N=838, AA N=60, Asians N=48, and Latinos N=28. Asian patients had the highest rate of oncogenic drivers with 39 (81%), followed by Latinos 19 (68%), Caucasians 511 (61%) and AA 32 (53%). In AA, EGFR mutation frequency was 22%, KRAS 17%, and ALK 4%. Asian patients were most likely to receive targeted therapies (51%), compared to 27% in AA. There were no significant differences in overall survival.
CONCLUSIONS
Differences are observed in the prevalence of oncogenic drivers in lung adenocarcinomas and consequent treatments among racial groups. The lowest frequency of drivers was seen in AA patients; however, over half of AA patients had a driver and those treated with targeted therapy outcomes similar to those of other races.