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Background
Non-small cell lung cancer (NSCLC) remains a significant global health concern, with EGFR mutations playing a pivotal role in guiding treatment decisions. This prospective study investigated the prevalence and clinical implications of EGFR mutations in Moroccan NSCLC patients.
Methods
A cohort of 302 NSCLC patients was analyzed for EGFR mutations using multiple techniques. Demographic, clinical, and pathological characteristics were assessed, and overall survival (OS) outcomes were compared among different EGFR mutation subtypes.
Results
EGFR mutations were present in 23.5% of patients, with common mutations (81.69%) dominating. Common mutations showed strong associations with female gender and non-smoking status, while rare mutations were associated with a positive smoking history. Patients with EGFR mutations receiving tyrosine kinase inhibitors (TKIs) had significantly improved OS compared to wild-type EGFR patients. Notably, patients with common EGFR mutations had the highest OS, while those with rare mutations had a shorter survival period, albeit not statistically significant.
Conclusion
This study highlights the relevance of EGFR mutation status in NSCLC patients, particularly in therapeutic decision-making. The association between smoking history and rare mutations suggests the need for tailored approaches. The survival advantage for patients with common EGFR mutations underscores the significance of personalized treatment strategies.

背景：非小细胞肺癌（Non-small cell lung cancer, NSCLC）仍是全球性重大健康问题，表皮生长因子受体（epidermal growth factor receptor, EGFR）突变在指导治疗决策中发挥着核心作用。本前瞻性研究旨在探讨摩洛哥非小细胞肺癌患者中EGFR突变的流行情况及其临床意义。
方法：本研究纳入302例非小细胞肺癌患者队列，采用多种检测技术分析其EGFR突变状态；收集并评估受试者的人口学特征、临床及病理资料，同时比较不同EGFR突变亚型患者的总生存期（overall survival, OS）结局。
结果：23.5%的患者检出EGFR突变，其中常见突变占比81.69%，为主要突变类型。常见EGFR突变与女性性别及非吸烟状态呈显著正相关，而罕见EGFR突变则与吸烟史阳性相关。接受酪氨酸激酶抑制剂（tyrosine kinase inhibitors, TKIs）治疗的EGFR突变患者，其总生存期显著优于EGFR野生型患者。值得注意的是，携带常见EGFR突变的患者总生存期最长，而罕见突变患者的生存期较短，但该差异未达到统计学显著性水平。
结论：本研究明确了EGFR突变状态在非小细胞肺癌患者诊疗中的重要价值，尤其对治疗决策具有指导意义。吸烟史与罕见EGFR突变的关联提示，临床需制定个体化的诊疗策略。携带常见EGFR突变患者的生存优势，进一步凸显了个性化治疗方案的临床必要性。