Comprehensive Genomic Profiling of Indian Patients With Lung Cancer.

IF 3.2 Q2 ONCOLOGY

JCO Global Oncology Pub Date : 2025-05-01 Epub Date: 2025-05-05 DOI:10.1200/GO-24-00587

Shivani Sharma, Vanita Noronha, Arti Yadav, Madhvi Mandhania, Sambit K Mohanty, Rahul Katara, Aditi Aggarwal, Sagar Samrat Mohanty, Akash Kumar, Sanjeev Kumar, Vipin Kumar, Kanika Jaggi, Deepak Kumar Sharma, Sanjay Kumar, Vaishalee Apoorva, Akash Pawar, Nandini Menon, Minit Shah, Kumar Prabhash

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Abstract

Purpose: Genomic profiling has revolutionized non-small cell lung cancer (NSCLC) therapy, but molecular data on Indian patients with NSCLC are limited.

Materials and methods: We analyzed next-generation sequencing (NGS) data of 5,219 Indian patients with lung cancer, tested between May 2022 and August 2023 at CORE Diagnostics, a commercial laboratory in India. Using the PulmoCORE gene panel, we targeted 13 key genes (ALK, BRAF, EGFR, ERBB2, KRAS, MAP2K1, MET, NRAS, PIK3CA, RET, ROS1, TP53, and NTRK) for DNA and RNA sequencing. PD-L1 was tested by immunohistochemistry.

Results: Median patient age was 62 years, and 62.5% were male. Common histologies included adenocarcinoma (57.1%), NSCLC not otherwise specified (19.3%), and squamous cell carcinoma (7%). Genomic alterations were detected in 80.6% patients according to the PulmoCORE panel; 64.2% patients had actionable alterations in at least one of the nine biomarkers with Food and Drug Administration-approved targeted therapies, that is, EGFR, KRAS, ALK, ROS1, BRAF, NTRK1/2/3, MET, RET, and ERBB2. Common alterations included TP53 (37%), EGFR (34.1%), and KRAS (13.3%), ALK (8.8%), and others below 5%. Alterations were more common in adenocarcinoma (76.4%) than in patients with squamous cell carcinoma (29.9%). Sex and age influenced mutation prevalence, with EGFR mutations more common in females and KRAS in males, while ALK, ROS1, and RET fusions were prevalent in younger adults. Most genomic alterations were mutually exclusive, although 25% patients had co-occurring mutations. PD-L1 positivity was higher in males (28.3%) and more common in patients with squamous cell carcinoma (34.2%).

Conclusion: Broad molecular profiling is important to detect actionable alterations in Indian patients with lung cancer, for delivering optimal personalized precision medicine. Our study underscores the fact that NGS should be routinely done before planning therapy in Indian patients with advanced lung cancer.

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印度肺癌患者的综合基因组分析。

目的：基因组分析已经彻底改变了非小细胞肺癌（NSCLC）的治疗，但印度NSCLC患者的分子数据有限。材料和方法：我们分析了5219名印度肺癌患者的下一代测序（NGS）数据，这些数据于2022年5月至2023年8月在印度的一家商业实验室CORE Diagnostics进行检测。使用PulmoCORE基因面板，我们针对13个关键基因（ALK、BRAF、EGFR、ERBB2、KRAS、MAP2K1、MET、NRAS、PIK3CA、RET、ROS1、TP53和NTRK）进行DNA和RNA测序。免疫组织化学检测PD-L1。结果：患者中位年龄为62岁，62.5%为男性。常见的组织学包括腺癌（57.1%）、非小细胞肺癌（19.3%）和鳞状细胞癌（7%）。根据PulmoCORE小组，80.6%的患者检测到基因组改变；64.2%的患者在经美国食品和药物管理局批准的靶向治疗的9种生物标志物中至少有一种发生了可操作的改变，即EGFR、KRAS、ALK、ROS1、BRAF、NTRK1/2/3、MET、RET和ERBB2。常见的改变包括TP53（37%）、EGFR（34.1%）、KRAS（13.3%）、ALK（8.8%）和其他低于5%的改变。腺癌患者（76.4%）比鳞状细胞癌患者（29.9%）更常见。性别和年龄影响突变发生率，EGFR突变在女性中更常见，KRAS在男性中更常见，而ALK、ROS1和RET融合在年轻人中更普遍。大多数基因组改变是相互排斥的，尽管25%的患者有共同发生的突变。PD-L1阳性在男性中较高（28.3%），在鳞状细胞癌患者中更常见（34.2%）。结论：广泛的分子谱分析对于检测印度肺癌患者可操作的改变非常重要，可以提供最佳的个性化精准医疗。我们的研究强调了这样一个事实，即NGS应该在印度晚期肺癌患者计划治疗之前进行常规检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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