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Co-mutations of epidermal growth factor receptor and BRAF in Chinese non-small cell lung cancer patients

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机构: [1]Oncology No. 2 Department, Guangdong Second Provincial General Hospital, Guangzhou, China [2]Department of Thoracic Surgery in the Aged, the First Affiliated Hospital of Kunming Medical University, Kunming, China [3]OrigiMed Co., Ltd., Shanghai, China [4]Thoracic Surgeons Department, Guangdong Second Provincial General Hospital, Guangzhou, China [5]Department of Thoracic Surgery, Yunnan Cancer Center, Kunming, China
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关键词: BRAF fusion epidermal growth factor receptor (EGFR) non-small cell lung cancer (NSCLC) co-mutation

摘要:
Background: Epidermal growth factor receptor (EGFR) and BRAF are 2 driver genes in non-small cell lung cancer (NSCLC) which are normally mutually exclusive. It has been previously reported that the existence of BRAF V600E in EGFR-mutated NSCLC patients could cause resistance to EGFR tyrosine kinase inhibitors (TKIs), but the influence of other BRAF actionable mutations on resistance to EGFR-TKIs has not yet been investigated. Understanding the coexistence of EGFR and BRAF actionable mutations in Chinese NSCLC patients may be essential for further treatment and prognostic prediction. Methods: A total of 127 Chinese NSCLC patients harboring EGFR and BRAF co-mutations were enrolled in this study. We analyzed the mutation profiles of these patients through next-generation sequencing (NGS). We explored the associations between somatic mutations and patient characteristics, including tumor stage and age, among others. Results: The frequency of EGFR and BRAF co-mutation was 0.91% in Chinese NSCLC patients, compared with 0.97% in Western NSCLC patients (cBioPortal). Among the 127 patients with both EGFR and BRAF mutations, 93 of them harbored clinically significant mutations. The remaining 34 patients were found to have mutations of uncertain significance of either EGFR or BRAF. TP53 was the most frequently mutated gene in BRAF and EGFR co-mutation patients, accounting for around 58% (N=54/93). MET active mutations (amplification and exon 14 skipping) accounted for 12% (N=11/93). Approximately 18% of patients (N=17/93) with significant EGFR mutations were detected to have fusions/rearrangements of the BRAF gene. BRAF fusion was more likely detected in EGFR exon19del patients compared with non-exon19del patients (P value =0.015). In addition, EGFR T790M, the most TKI-resistant mutation, was not found in any patient with BRAF fusion/rearrangement. Conclusions: This study is the first to show different subtypes of EGFR and BRAF co-mutations in Chinese NSCLC patients. The prognosis of EGFR-TKI treatment may vary according to different BRAF actionable mutations. Aside from BRAF V600E, class II/III and BRAF fusions were found, which provides clues for investigating the resistance mechanisms of EGFR-TKIs in the future.

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出版当年[2022]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验 4 区 肿瘤学
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Q3 MEDICINE, RESEARCH & EXPERIMENTAL Q3 ONCOLOGY
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第一作者机构: [1]Oncology No. 2 Department, Guangdong Second Provincial General Hospital, Guangzhou, China
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通讯机构: [4]Thoracic Surgeons Department, Guangdong Second Provincial General Hospital, Guangzhou, China [5]Department of Thoracic Surgery, Yunnan Cancer Center, Kunming, China [*1]Thoracic Surgeons Department, Guangdong Second Provincial General Hospital, Guangzhou, China. [*2]Department of Thoracic Surgery, Yunnan Cancer Center, No.519, Kun Zhou Road, Xi-shan District, Kunming 650000, China.
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