Characteristics of gene mutations and prognosis of patients with advanced lung cancer in Guangzhou, China

Objective Lung cancer is the most common type of cancer, patients with non-small cell lung cancer (NSCLC) can easily miss the best treatment opportunity in the early stages due to the lack of specificity in symptoms. Considering next-generation sequencing (NGS) can identify specific gene mutations carried by tumor cells to guide treatment, we aimed to analyze the mutation characteristics of lung cancer patients in Guangzhou, China.Methods A total of 106 patients diagnosed with lung cancer in Guangzhou First People's Hospital from January 1, 2018 to December 31, 2021 were retrospectively enrolled.Results The patients were divided into EGFR-TKI sensitivity group (N=38) and non-EGFR-TKI sensitivity group (N=68) according to the results of NGS. The mutation types of the EGFR-TKI sensitivity group gene were level 1 biomarker EGFR 19Del (N=17) and 21 L858R (N=21). EGFR mutations mostly occurred in women, non-smokers, and non-drinkers, and the pathological types were adenocarcinoma, and 30 patients with EGFR mutations received targeted therapy. The mutation type of the Non-EGFR-TKI sensitivity group gene was mainly level 1 biomarker KRAS (N=14), with the main mutation site was G12C (N=7), and the mutations of G12C, G12A and G12V were seen in smokers, and G12D and G12S mutations were seen in nonsmokers. Other level 1 or 2 biomarkers include EGFR, ERBB2, MET amplification, RET, ROS, and ALK. EGFR and KRAS mutations were only found in patients with lung adenocarcinoma, and gene mutations were found in 8 cases (53.33%) of lung squamous cell carcinoma, and the main mutation types were PIK3CA (N=4) and FGFR1 mutation (N=2). Of the 26 FDA-approved patients with level 1 or 2 biomarkers, 11 received targeted therapy. Among all patients, the median progression-free survival was 24 months and the median overall survival was 56 months, which was significantly better than other treatments.Conclusion The most common gene mutations in patients with advanced lung adenocarcinoma in Guangzhou, China are TP53, EGFR and KRAS, and the common gene mutations in lung squamous cell carcinoma are PIK3CA and FGFR1. Improving gene sequencing can help patients make better treatment choices, prolong progression-free survival and overall survival, and is of great significance for improving patients' prognosis and quality of life.