Genetic Mutation Screen in Early Lung Cancer Specimens

Clin Lung Cancer. 2013 Nov 14. pii: S1525-7304(13)00231-3. doi: 10.1016/j.cllc.2013.11.005. [Epub ahead of print]

Genetic Mutation Screen in Early Non-Small-Cell Lung Cancer (NSCLC) Specimens.

Bar J1, Damianovich M2, Hout Siloni G2, Dar E2, Cohen Y2, Perelman M3, Ben Nun A4, Simansky D4, Yellin A4, Urban D5, Onn A6.

Author information

• 1Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel; Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel. Electronic address: bar.jair@gmail.com.
• 2Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel.
• 3Institute of Pathology, Sheba Medical Center, Tel-Hashomer, Israel.
• 4Thoracic Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
• 5Peter MacCallum Cancer Center, East Melbourne, Victoria, Australia.
• 6Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel; Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel.

Abstract

BACKGROUND:

Testing for genetic abnormalities in epithelial growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and potentially additional genes is a critical tool in the care of advanced NSCLC. There is conflicting evidence for the role of such tests in early NSCLC. We report a single-institute Sequenom testing for a wide range of mutations and their clinical correlations in early-resected NSCLC specimens.

MATERIALS AND METHODS:

Early NSCLC paraffin-embedded, formalin-fixed (FFPE) specimens were collected, DNA extracted, and using Sequenom-based matrix-assisted laser desorption/ionization-time of flight analysis, mutations in 22 oncogenes and tumor suppressor genes were evaluated. Clinical data was collected retrospectively.

RESULTS:

The technique was found to be feasible. Thirty-six of 96 patients (37.5%) had any genetic abnormality identified, and 8 (8.3%) had 2 or more mutations. Kirsten rat sarcoma viral oncogene homolog (KRAS) and EGFR were the most common genes to appear mutated (15.6%); phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) was the gene to be found most commonly in tumors with co-mutations. Transversions were found mostly in KRAS gene mutations and to be nonprognostic. No difference in the spectrum of mutations was found between squamous-cell and non-squamous-cell lung cancers. Ever-smokers showed a trend for worse prognosis, with a similar spectrum of mutations.

CONCLUSION:

Sequenom-based mutation screen is feasible using FFPE samples. More than a third of the patients were found to harbor some genetic abnormality, and 8% were found to have more than a single mutated gene. Wide-range gene screens using large sample depositories are required for further insight into the important genes at play in early NSCLC.