AUTHOR=Zhou Yongchun , Ge Feng , Du Yaxi , Li Quan , Cai Jingjing , Liu Xin , Guo Yinjin , Shen Zhenghai , Duan Lincan , Huang Zhan , Yao Fei , Zhu Changbin , Shi Hutao , Huang Yunchao 

TITLE=Unique Profile of Driver Gene Mutations in Patients With Non-Small-Cell Lung Cancer in Qujing City, Yunnan Province, Southwest China

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.644895

DOI=10.3389/fonc.2021.644895

ISSN=2234-943X

ABSTRACT=<sec><title>Objective</title><p>Qujing City, Yunnan Province, China, has a high incidence of lung cancer and related mortality. The etiology of NSCLC in Qujing area and distribution of associated molecular aberrations has not been fully elucidated. This study aimed to reveal the profile of driver gene mutations in patients with non-small-cell lung cancer (NSCLC) in Qujing and explore their relationships with clinicopathological characteristics.</p></sec><sec><title>Methods</title><p>In this study, the mutation profiles of NSCLC driver genes, including <italic>EGFR, ALK, ROS1, KRAS, BRAF, RET, MET, HER2, NRAS</italic>, and <italic>PIK3CA</italic>, were investigated in patients with NSCLC from Qujing and compared with those from other regions in Yunnan Province. The associations between molecular mutations and clinicopathological characteristics were further analyzed.</p></sec><sec><title>Results</title><p>A distinct profile of driver gene mutations was discovered in patients with NSCLC from Qujing. Interestingly, a higher proportion of <italic>EGFR</italic> compound mutations, including G719X + S768I (19.65% vs 3.38%, P &lt; 0.0001) and G719X + L861Q (21.10% vs 2.82%, P &lt; 0.0001), was observed in patients with NSCLC in Qujing compared with patients in non-Qujing area, besides significantly different distributions of <italic>EGFR</italic> (46.01% vs. 51.07%, <italic>P</italic> = 0.0125), <italic>ALK</italic> (3.17% vs. 6.97%, <italic>P</italic> = 0.0012), <italic>ROS1</italic> (0.5% vs. 2.02%, <italic>P</italic> = 0.0113), and <italic>KRAS</italic> (23.02% vs. 7.85%, <italic>P</italic> &lt; 0.0001). Further, <italic>EGFR</italic> compound mutations were more likely associated with the occupation of patients (living/working in rural areas, e.g., farmers). Moreover, <italic>KRAS</italic> G12C was the dominant subtype (51.11% vs 25.00%, <italic>P</italic> = 0.0275) among patients with NSCLC having <italic>KRAS</italic> mutations in Qujing.</p></sec><sec><title>Conclusions</title><p>Patients with NSCLC in Qujing displayed a unique profile of driver gene mutations, especially a higher prevalence of <italic>EGFR</italic> compound mutations and dominant <italic>KRAS</italic> G12C subtype, in this study, indicating a peculiar etiology of NSCLC in Qujing. Therefore, a different paradigm of therapeutic strategy might need to be considered for patients with NSCLC in Qujing.</p></sec>