Abstract

PurposeThe identification of genomic alterations related to recurrence in early-stage non-small cell lung cancer (NSCLC) patients may help better stratify high-risk individuals and guide treatment strategies. This study aimed to identify the molecular biomarkers of recurrence in early-stage NSCLC.ResultsOf the 42 tumors evaluable for genomic alterations, TP53 and EGFR were the most frequent alterations with population frequency 52.4% and 50.0%, respectively. Fusion genes were detected in four patients, which had lower mutational burden and relatively better genomic stability. EGFR mutation and fusion gene were mutually exclusive in this study. CDKN2A, FAS, SUFU and SMARCA4 genomic alterations were only observed in the relapsed patients. Increased copy number alteration index was observed in early relapsed patients. Among these genomic alterations, early-stage NSCLCs harboring CDKN2A, FAS, SUFU and SMARCA4 genomic alterations were found to be significantly associated with recurrence. Some of these new findings were validated using The Cancer Genome Atlas (TCGA) dataset.ConclusionsThe genomic alterations of CDKN2A, FAS, SUFU and SMARCA4 in early-stage NSCLC are found to be associated with recurrence, but confirmation in a larger independent cohort is required to define the clinical impact.Materials and MethodsPaired primary tumor and normal lung tissue samples were collected for targeted next-generation sequencing analysis. A panel targets exons for 440 genes was used to assess the mutational and copy number status of selected genes in three clinically relevant groups of stage I/II NSCLC patients: 1) Early relapse; 2) Late relapse; and 3) No relapse.

Highlights

  • Genomic alterationsLung cancer is the leading cause of cancer-related mortality in the world, and non-small cell lung cancer (NSCLC) accounts for 80–85% of all lung cancers [1]

  • EGFR mutation and fusion gene were mutually exclusive in this study

  • CDKN2A, FAS, SUFU and SMARCA4 genomic alterations were only observed in the relapsed patients

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Summary

Introduction

Genomic alterationsLung cancer is the leading cause of cancer-related mortality in the world, and non-small cell lung cancer (NSCLC) accounts for 80–85% of all lung cancers [1]. Current treatment for NSCLC is mainly based on the clinical staging systems in addition to some factors, such as smoking history, gender and genetic mutation [2, 3]. The 5-year survival rate of NSCLC patients is about 30–60%, with local recurrence and metastasis being the leading causes of death [4]. Even after the entire resection of tumor, 30–55% of patients will develop disease recurrence within the first five years of surgery and die of the disease [4,5,6,7,8]. Identification of patients with high risk of recurrence may help to guide more tailored treatment plan for the individual patient, in particular for those who may receive additional benefit from adjuvant therapy and targeted therapy

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