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Clin Cancer Res. 2018 Mar 1;24(5):1038-1047. doi: 10.1158/1078-0432.CCR-17-2289. Epub 2017 Dec 7.

The Impact of Smoking and TP53 Mutations in Lung Adenocarcinoma Patients with Targetable Mutations-The Lung Cancer Mutation Consortium (LCMC2).

Author information

1
University of Colorado Cancer Center, Aurora, Colorado. dk@rics.bwh.harvard.edu dara.aisner@ucdenver.edu.
2
Brigham and Women's Hospital, Boston, Massachusetts.
3
Dana-Farber Cancer Institute, Boston, Massachusetts.
4
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee.
5
Winship Cancer Institute of Emory University, Atlanta, Georgia.
6
The University of Texas MD Anderson Cancer Center, Houston, Texas.
7
Memorial Sloan Kettering Cancer Center, New York, New York.
8
University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.
9
Ohio State Comprehensive Cancer Center, Columbus, Ohio.
10
H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
11
Yale University Medical Center, New Haven, Connecticut.
12
Oregon Health Sciences University, Portland, Oregon.
13
David Geffen School of Medicine, University of California, Los Angeles, California.
14
University of Texas Southwestern, Medical Center, Dallas, Texas.
15
Washington University School of Medicine, St. Louis, Missouri.
16
Massachusetts General Hospital, Boston, Masschusetts.
17
The Johns Hopkins University, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland.
18
University of Colorado Cancer Center, Aurora, Colorado.
19
Brigham and Women's Hospital, Boston, Massachusetts. dk@rics.bwh.harvard.edu dara.aisner@ucdenver.edu.
#
Contributed equally

Abstract

Purpose: Multiplex genomic profiling is standard of care for patients with advanced lung adenocarcinomas. The Lung Cancer Mutation Consortium (LCMC) is a multi-institutional effort to identify and treat oncogenic driver events in patients with lung adenocarcinomas.Experimental Design: Sixteen U.S. institutions enrolled 1,367 patients with lung cancer in LCMC2; 904 were deemed eligible and had at least one of 14 cancer-related genes profiled using validated methods including genotyping, massively parallel sequencing, and IHC.Results: The use of targeted therapies in patients with EGFR, ERBB2, or BRAF p.V600E mutations, ALK, ROS1, or RET rearrangements, or MET amplification was associated with a survival increment of 1.5 years compared with those with such mutations not receiving targeted therapy, and 1.0 year compared with those lacking a targetable driver. Importantly, 60 patients with a history of smoking derived similar survival benefit from targeted therapy for alterations in EGFR/ALK/ROS1, when compared with 75 never smokers with the same alterations. In addition, coexisting TP53 mutations were associated with shorter survival among patients with EGFR, ALK, or ROS1 alterations.Conclusion: Patients with adenocarcinoma of the lung and an oncogenic driver mutation treated with effective targeted therapy have a longer survival, regardless of prior smoking history. Molecular testing should be performed on all individuals with lung adenocarcinomas irrespective of clinical characteristics. Routine use of massively parallel sequencing enables detection of both targetable driver alterations and tumor suppressor gene and other alterations that have potential significance for therapy selection and as predictive markers for the efficacy of treatment. Clin Cancer Res; 24(5); 1038-47. ©2017 AACR.

PMID:
29217530
DOI:
10.1158/1078-0432.CCR-17-2289
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