Long-term prognosis of patients with cancer-related mutations in non-tumoral lung

Abstract

Introduction: In two previous cohorts we demonstrated that EGFR/KRAS mutations can be present in non-tumoral lung tissue (NTLT) regardless tumor genomic status. In cohort one (J Clin Med. 2019) the presence of these mutations was associated with a worse prognosis (disease-free survival), while in cohort two the presence of NTLT mutations in EGFR and KRAS was demonstrated even in the absence of mutations in the primary tumor (no differences in prognosis were found due to small sample size). The objective of this study is to analyze the 5-year prognosis of both cohorts and assess whether the presence of driver-mutations in NTLT is associated with a higher overall mortality in patients with localized ADC. We present the preliminary results Methods: 78 patients were included (47 from the first cohort and 31 from the second one). After tumor genotyping, the EGFR/KRAS status of the NTLT was performed with real-time PCR Results: two patients did not continued the follow-up. The remaining completed the 36-months follow-up and 77% have completed the 5-year follow-up at the time of the analysis. 13 (16.7%) patients had mutations in the EGFR and/or KRAS in the NTLT (M-NTLT group). At 60 months, 53.8% of M-NTLT group patients had distant recurrence vs 32.3%. Overall mortality was higher in the M-NTLT group: average survival of 40.5 months vs 54.8 (-14.3 months, Log-rank p=0.003). These results are independent of the type of mutation, cancer treatment and preoperative stage Conclusion: based on two single-center cohorts, we can conclude that in patients with localized ADC, having EGFR or KRAS mutations in NTLT is associated with a higher risk of death. These data reaffirm the results of our previous studies