Assessing mutation-clinical correlations and treatment outcomes in Vietnamese non-small cell lung cancer patients

Introduction

This study examines the genetic and clinical profiles of Vietnamese patients with non-small cell lung cancer (NSCLC), focusing on mutations in seven driver genes: EGFR, KRAS, NRAS, BRAF, ALK, ROS1, and PIK3CA. The goal is to identify mutation patterns and their correlations with clinical factors, thereby informing personalized treatment strategies.

Materials and methods

A cross-sectional study of 299 NSCLC patients at the University Medical Center, Ho Chi Minh City (2019–2022) recorded demographics, smoking history, and tumor stage. Pre-treatment samples were analyzed via massively parallel sequencing, and survival analysis assessed the impact of EGFR/KRAS mutations on survival and TKI response.

Results

Most patients (88.6 %) were diagnosed at stage IV. EGFR mutations were found in 43.5 % of cases, predominantly in female non-smokers, while KRAS mutations (15.4 %) were more common in male smokers. EGFR exon 19 deletions (46.3 %) and L858R (39.0 %) were the most frequent, with KRAS G12C (29.8 %) as the dominant variant. EGFR-mutant patients treated with TKIs had significantly longer survival (p = 0.027); however, no survival difference was observed between the EGFR- and KRAS-mutated groups. Co-mutations (3.7 %) were rare but may indicate resistance. Logistic regression confirmed EGFR mutations' association with female non-smokers and KRAS mutations with male smokers.

Conclusions

Genetic profiling in Vietnamese NSCLC patients reveals a high prevalence of actionable driver mutations, supporting the integration of routine molecular testing into NSCLC management. EGFR-mutated patients derive significant benefits from TKI therapy, underscoring the importance of personalized treatment strategies. Further research is needed to investigate resistance mechanisms and refine targeted therapeutic approaches.