{"title":"非小细胞肺癌患者驱动基因改变的基因组分析，治疗模式和对生存结果的影响：1200多名患者的单中心经验。","authors":"Minit Shah, Vanita Noronha, Vijay Patil, Ajay Kumar Singh, Nandini Menon, Supriya Goud, Srushti Shah, Sucheta More, Akhil Kapoor, Bal Krishna Mishra, Pratik Chandrani, Anuradha Chougule, Vinod Gupta, Priyanka Pange, Omshree Shetty, Trupti Pai, Rajiv Kaushal, Subhash Yadav, Moitrri Basu, Deep Vora, Arvind Vaidyanathan, Prashant Kumar, Rohan Jacob, Anjali Shah, Rashmi Ranjan Pradhan, Debdeep Samaddar, Vallish Shenoy, Bhanupratap Singh, Raveendranath Puviarasan, Saurabh Bagra, Rachit Desai, Elveera Saldanha, Disha Poojary, Akash Pathak, Shivangi Ray, Himanshu Bhardwaj, Ujwal Shetty, Ramya Iyer, Richa Das, Neha Mer, Hetakshi Shah, Yuvraj Kaushal, Ananya Singh, Hrutika Panmand, Ganesh Gosavi, Ahmad Ubharay, Anusha Iyer, Ushaan Turel, Ankush Shetake, Kamesh Maske, Amit Janu, Nilendu Purandare, Akash Pawar, Madhvi Mandhania, Kumar Prabhash","doi":"10.1016/j.cllc.2025.02.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The utility of Next-Generation-Sequencing (NGS) in patients of non-small-cell-lung-cancer (NSCLC) has led to an exponential increase in the identification of driver-gene alterations, however, Indian NGS data was lacking.</p><p><strong>Materials and methods: </strong>This retrospective study conducted between May'2019 and Dec'2023 included histologically confirmed NSCLC cases with NGS testing done on tissue and/or liquid biopsy samples prior to treatment initiation. We reported the frequency of driver-gene alterations, clinicopathological profile, treatment patterns, and outcomes [Overall-Survival (OS)].</p><p><strong>Results: </strong>Data of 1230 patients was analyzed. Median age was 59 years (IQR,51-66), 65.3% (n = 803) were males, 34.6% (n = 426) had a history of smoking, and 78.1% (n = 961) had an adenocarcinoma histology. NCCN-recommended driver-gene alterations were seen in 64.8% (n = 797) cases. EGFR, ALK, ROS1, ERBB2, MET, RET, NTRK, BRAF and KRAS gene alterations were seen in 33.7% (n = 414), 7.6% (n = 94), 2.4% (n = 29), 6.1% (n = 75), 1.9% (n = 23), 2.2% (n = 22), 0.7% (n = 8), 3.3% (n = 40), and 9.6% (n = 118) cases respectively. 62.1% (n = 495/797) driver-positive patients could receive targeted therapy, and 21.7% (n = 94/433) driver-negative patients could receive immunotherapy. With the receipt of targeted therapy, median-OS of driver-positive patients was 26.7 months (95%CI, 23.3-32.7) versus 9.3 months (95%CI, 7.3-12.2, P < .001) without. Similarly, in driver-negative patients, median OS with the receipt of immunotherapy was 16.4months (95%CI, 14.7-24.4) versus 11.5 months (95%CI, 9.0-13.4, P = .006) without.</p><p><strong>Conclusion: </strong>All eligible NSCLC patients must undergo molecular testing by appropriately chosen and cost-effective methods at diagnosis. Wherever possible, this should be done by NGS. Efforts should focus on improving access to targeted agents in India, and developing cost-effective alternatives.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Genomic Profiling of Driver Gene Alterations in Patients With Non-Small Cell Lung Cancer, Patterns of Treatment and Impact on Survival Outcomes: A Single Center Experience of More Than 1200 Patients.\",\"authors\":\"Minit Shah, Vanita Noronha, Vijay Patil, Ajay Kumar Singh, Nandini Menon, Supriya Goud, Srushti Shah, Sucheta More, Akhil Kapoor, Bal Krishna Mishra, Pratik Chandrani, Anuradha Chougule, Vinod Gupta, Priyanka Pange, Omshree Shetty, Trupti Pai, Rajiv Kaushal, Subhash Yadav, Moitrri Basu, Deep Vora, Arvind Vaidyanathan, Prashant Kumar, Rohan Jacob, Anjali Shah, Rashmi Ranjan Pradhan, Debdeep Samaddar, Vallish Shenoy, Bhanupratap Singh, Raveendranath Puviarasan, Saurabh Bagra, Rachit Desai, Elveera Saldanha, Disha Poojary, Akash Pathak, Shivangi Ray, Himanshu Bhardwaj, Ujwal Shetty, Ramya Iyer, Richa Das, Neha Mer, Hetakshi Shah, Yuvraj Kaushal, Ananya Singh, Hrutika Panmand, Ganesh Gosavi, Ahmad Ubharay, Anusha Iyer, Ushaan Turel, Ankush Shetake, Kamesh Maske, Amit Janu, Nilendu Purandare, Akash Pawar, Madhvi Mandhania, Kumar Prabhash\",\"doi\":\"10.1016/j.cllc.2025.02.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The utility of Next-Generation-Sequencing (NGS) in patients of non-small-cell-lung-cancer (NSCLC) has led to an exponential increase in the identification of driver-gene alterations, however, Indian NGS data was lacking.</p><p><strong>Materials and methods: </strong>This retrospective study conducted between May'2019 and Dec'2023 included histologically confirmed NSCLC cases with NGS testing done on tissue and/or liquid biopsy samples prior to treatment initiation. We reported the frequency of driver-gene alterations, clinicopathological profile, treatment patterns, and outcomes [Overall-Survival (OS)].</p><p><strong>Results: </strong>Data of 1230 patients was analyzed. Median age was 59 years (IQR,51-66), 65.3% (n = 803) were males, 34.6% (n = 426) had a history of smoking, and 78.1% (n = 961) had an adenocarcinoma histology. NCCN-recommended driver-gene alterations were seen in 64.8% (n = 797) cases. EGFR, ALK, ROS1, ERBB2, MET, RET, NTRK, BRAF and KRAS gene alterations were seen in 33.7% (n = 414), 7.6% (n = 94), 2.4% (n = 29), 6.1% (n = 75), 1.9% (n = 23), 2.2% (n = 22), 0.7% (n = 8), 3.3% (n = 40), and 9.6% (n = 118) cases respectively. 62.1% (n = 495/797) driver-positive patients could receive targeted therapy, and 21.7% (n = 94/433) driver-negative patients could receive immunotherapy. With the receipt of targeted therapy, median-OS of driver-positive patients was 26.7 months (95%CI, 23.3-32.7) versus 9.3 months (95%CI, 7.3-12.2, P < .001) without. Similarly, in driver-negative patients, median OS with the receipt of immunotherapy was 16.4months (95%CI, 14.7-24.4) versus 11.5 months (95%CI, 9.0-13.4, P = .006) without.</p><p><strong>Conclusion: </strong>All eligible NSCLC patients must undergo molecular testing by appropriately chosen and cost-effective methods at diagnosis. Wherever possible, this should be done by NGS. Efforts should focus on improving access to targeted agents in India, and developing cost-effective alternatives.</p>\",\"PeriodicalId\":10490,\"journal\":{\"name\":\"Clinical lung cancer\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-02-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical lung cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cllc.2025.02.001\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical lung cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cllc.2025.02.001","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Genomic Profiling of Driver Gene Alterations in Patients With Non-Small Cell Lung Cancer, Patterns of Treatment and Impact on Survival Outcomes: A Single Center Experience of More Than 1200 Patients.
Background: The utility of Next-Generation-Sequencing (NGS) in patients of non-small-cell-lung-cancer (NSCLC) has led to an exponential increase in the identification of driver-gene alterations, however, Indian NGS data was lacking.
Materials and methods: This retrospective study conducted between May'2019 and Dec'2023 included histologically confirmed NSCLC cases with NGS testing done on tissue and/or liquid biopsy samples prior to treatment initiation. We reported the frequency of driver-gene alterations, clinicopathological profile, treatment patterns, and outcomes [Overall-Survival (OS)].
Results: Data of 1230 patients was analyzed. Median age was 59 years (IQR,51-66), 65.3% (n = 803) were males, 34.6% (n = 426) had a history of smoking, and 78.1% (n = 961) had an adenocarcinoma histology. NCCN-recommended driver-gene alterations were seen in 64.8% (n = 797) cases. EGFR, ALK, ROS1, ERBB2, MET, RET, NTRK, BRAF and KRAS gene alterations were seen in 33.7% (n = 414), 7.6% (n = 94), 2.4% (n = 29), 6.1% (n = 75), 1.9% (n = 23), 2.2% (n = 22), 0.7% (n = 8), 3.3% (n = 40), and 9.6% (n = 118) cases respectively. 62.1% (n = 495/797) driver-positive patients could receive targeted therapy, and 21.7% (n = 94/433) driver-negative patients could receive immunotherapy. With the receipt of targeted therapy, median-OS of driver-positive patients was 26.7 months (95%CI, 23.3-32.7) versus 9.3 months (95%CI, 7.3-12.2, P < .001) without. Similarly, in driver-negative patients, median OS with the receipt of immunotherapy was 16.4months (95%CI, 14.7-24.4) versus 11.5 months (95%CI, 9.0-13.4, P = .006) without.
Conclusion: All eligible NSCLC patients must undergo molecular testing by appropriately chosen and cost-effective methods at diagnosis. Wherever possible, this should be done by NGS. Efforts should focus on improving access to targeted agents in India, and developing cost-effective alternatives.
期刊介绍：
Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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