Multi-institutional oncogenic driver mutation analysis in lung adenocarcinoma: The Lung Cancer Mutation Consortium Experience Journal Article


Authors: Sholl, L. M.; Aisner, D. L.; Varella-Garcia, M.; Berry, L. D.; Dias-Santagata, D.; Wistuba, I. I.; Chen, H.; Fujimoto, J.; Kugler, K.; Franklin, W. A.; Iafrate, A. J.; Ladanyi, M.; Kris, M. G.; Johnson, B. E.; Bunn, P. A.; Minna, J. D.; Kwiatkowski, D. J.
Article Title: Multi-institutional oncogenic driver mutation analysis in lung adenocarcinoma: The Lung Cancer Mutation Consortium Experience
Abstract: Introduction: Molecular genetic analyses of lung adenocarcinoma have recently become standard of care for treatment selection. The Lung Cancer Mutation Consortium was formed to enable collaborative multi-institutional analyses of 10 potential oncogenic driver mutations. Technical aspects of testing and clinicopathologic correlations are presented. Methods: Mutation testing in at least one of the eight genes (epidermal growth factor receptor [EGFR], KRAS, ERBB2, AKT1, BRAF, MEK1, NRAS, and PIK3CA) using SNaPshot, mass spectrometry, Sanger sequencing+/- peptide nucleic acid and/or sizing assays, along with anaplastic lymphoma kinase (ALK) and/or MET fluorescence in situ hybridization, were performed in six labs on 1007 patients from 14 institutions. Results: In all, 1007 specimens had mutation analysis performed, and 733 specimens had all 10 genes analyzed. Mutation identification rates did not vary by analytic method. Biopsy and cytology specimens were inadequate for testing in 26% and 35% of cases compared with 5% of surgical specimens. Among the 1007 cases with mutation analysis performed, EGFR, KRAS, ALK, and ERBB2 alterations were detected in 22%, 25%, 8.5%, and 2.4% of cases, respectively. EGFR mutations were highly associated with female sex, Asian race, and never-smoking status; and less strongly associated with stage IV disease, presence of bone metastases, and absence of adrenal metastases. ALK rearrangements were strongly associated with never-smoking status and more weakly associated with presence of liver metastases. ERBB2 mutations were strongly associated with Asian race and never-smoking status. Two mutations were seen in 2.7% of samples, all but one of which involved one or more of PIK3CA, ALK, or MET. Conclusion: Multi-institutional molecular analysis across multiple platforms, sample types, and institutions can yield consistent results and novel clinicopathological observations. © 2015 by the International Association for the Study of Lung Cancer.
Keywords: controlled study; major clinical study; mutation; bone metastasis; proto oncogene; smoking; mutational analysis; lung adenocarcinoma; fluorescence in situ hybridization; gene rearrangement; egfr gene; oncogene k ras; fish; pik3ca gene; akt1 gene; braf gene; adrenal metastasis; genotyping; oncogene n ras; map2k1 gene; human; male; female; priority journal; article; lcmc
Journal Title: Journal of Thoracic Oncology
Volume: 10
Issue: 5
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2015-05-01
Start Page: 768
End Page: 777
Language: English
DOI: 10.1097/jto.0000000000000516
PROVIDER: scopus
PMCID: PMC4410843
PUBMED: 25738220
DOI/URL:
Notes: Export Date: 2 September 2015 -- Source: Scopus
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  1. Marc Ladanyi
    1326 Ladanyi
  2. Mark Kris
    869 Kris