Higher Prevalence and Poorer Prognosis of EGFR Mutant Lung Adenocarcinoma in US Hispanics

Abstract

Introduction: Activating mutations in Epidermal growth factor receptor (EGFR) occur in approximately 15% White, 40-50% of Asian and 15% of Black patients with lung adenocarcinoma. However, its prevalence in the nearly 60 million U.S. Hispanics/Latinos has not been well characterized. Herein we evaluate EGFR mutation frequency in U.S. Hispanic/Latino patients with lung adenocarcinoma at an academic institute serving a large multi-ethnic area. Methods: We queried our prospective database (2015-2019) for lung adenocarcinoma patients who underwent surgical resection and had routine mutational analysis by a targeted gene panel. We identified 768 patients and were able to stratify 668 patients by self-identified race/ethnicity. We compared demographics (chi-square) and survival (Kaplan-Meier). Results: From 2015-2019, 668 patients met inclusion criteria and were evaluated for incidence of common targetable EGFR mutations. EGFR mutations were present in 30% of all patients with Hispanics/Latino experiencing an incidence of 35%, significantly more than non-Hispanic White patients, p=0.019. Overall survival at 3 years was not significantly different amongst racial/ethnic groups. However, in patients with EGFR mutations, 3-year overall survival was significantly worse in Hispanic/Latino patients in comparison to non-Hispanic White patients (62% vs 96%, p=0.021). There was no difference in the pathologic stage or surgical procedure amongst racial/ethnic groups. Discussion: Approximately one-third of U.S. Hispanics with lung adenocarcinoma displayed EGFR mutations which were associated with decreased overall survival compared to White and Asian patients. Increasing mutational analysis and investigation of biological differences of this growing ethnic group is essential for optimal targeted treatment strategies as well as in the design of future clinical trials.