The impact of smoking and tp53 mutations in lung adenocarcinoma patients with targetable mutations—the lung cancer mutation consortium (LCMC2)

Dara L. Aisner, Lynette M. Sholl, Lynne D. Berry, Michael R. Rossi, Heidi Chen, Junya Fujimoto, Andre L. Moreira, Suresh S. Ramalingam, Liza C. Villaruz, Gregory A. Otterson, Eric Haura, Katerina Politi, Bonnie Glisson, Jeremy Cetnar, Edward B. Garon, Joan Schiller, Saiama N. Waqar, Lecia V. Sequist, Julie Brahmer, Yu Shyr & 7 others Kelly Kugler, Ignacio I. Wistuba, Bruce E. Johnson, John D. Minna, Mark G. Kris, Paul A. Bunn, David J. Kwiatkowski

Research output: Contribution to journalArticle

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Abstract

Purpose: Multiplex genomic profiling is standard of care for patients with advanced lung adenocarcinomas. The Lung Cancer Mutation Consortium (LCMC) is a multi-institutional effort to identify and treat oncogenic driver events in patients with lung adenocarcinomas. Experimental Design: Sixteen U.S. institutions enrolled 1,367 patients with lung cancer in LCMC2; 904 were deemed eligible and had at least one of 14 cancer-related genes profiled using validated methods including genotyping, massively parallel sequencing, and IHC. Results: The use of targeted therapies in patients with EGFR, ERBB2, or BRAF p.V600E mutations, ALK, ROS1, or RET rearrangements, or MET amplification was associated with a survival increment of 1.5 years compared with those with such mutations not receiving targeted therapy, and 1.0 year compared with those lacking a targetable driver. Importantly, 60 patients with a history of smoking derived similar survival benefit from targeted therapy for alterations in EGFR/ALK/ ROS1, when compared with 75 never smokers with the same alterations. In addition, coexisting TP53 mutations were associated with shorter survival among patients with EGFR, ALK, or ROS1 alterations. Conclusion: Patients with adenocarcinoma of the lung and an oncogenic driver mutation treated with effective targeted therapy have a longer survival, regardless of prior smoking history. Molecular testing should be performed on all individuals with lung adenocarcinomas irrespective of clinical characteristics. Routine use of massively parallel sequencing enables detection of both targetable driver alterations and tumor suppressor gene and other alterations that have potential significance for therapy selection and as predictive markers for the efficacy of treatment.

Original languageEnglish (US)
Pages (from-to)1038-1047
Number of pages10
JournalClinical Cancer Research
Volume24
Issue number5
DOIs
StatePublished - Mar 1 2018

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Lung Neoplasms
Smoking
Mutation
High-Throughput Nucleotide Sequencing
Survival
Therapeutics
Neoplasm Genes
Standard of Care
Adenocarcinoma of lung
Tumor Suppressor Genes
Research Design
History

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The impact of smoking and tp53 mutations in lung adenocarcinoma patients with targetable mutations—the lung cancer mutation consortium (LCMC2). / Aisner, Dara L.; Sholl, Lynette M.; Berry, Lynne D.; Rossi, Michael R.; Chen, Heidi; Fujimoto, Junya; Moreira, Andre L.; Ramalingam, Suresh S.; Villaruz, Liza C.; Otterson, Gregory A.; Haura, Eric; Politi, Katerina; Glisson, Bonnie; Cetnar, Jeremy; Garon, Edward B.; Schiller, Joan; Waqar, Saiama N.; Sequist, Lecia V.; Brahmer, Julie; Shyr, Yu; Kugler, Kelly; Wistuba, Ignacio I.; Johnson, Bruce E.; Minna, John D.; Kris, Mark G.; Bunn, Paul A.; Kwiatkowski, David J.

In: Clinical Cancer Research, Vol. 24, No. 5, 01.03.2018, p. 1038-1047.

Research output: Contribution to journalArticle

Aisner, DL, Sholl, LM, Berry, LD, Rossi, MR, Chen, H, Fujimoto, J, Moreira, AL, Ramalingam, SS, Villaruz, LC, Otterson, GA, Haura, E, Politi, K, Glisson, B, Cetnar, J, Garon, EB, Schiller, J, Waqar, SN, Sequist, LV, Brahmer, J, Shyr, Y, Kugler, K, Wistuba, II, Johnson, BE, Minna, JD, Kris, MG, Bunn, PA & Kwiatkowski, DJ 2018, 'The impact of smoking and tp53 mutations in lung adenocarcinoma patients with targetable mutations—the lung cancer mutation consortium (LCMC2)', Clinical Cancer Research, vol. 24, no. 5, pp. 1038-1047. https://doi.org/10.1158/1078-0432.CCR-17-2289
Aisner, Dara L. ; Sholl, Lynette M. ; Berry, Lynne D. ; Rossi, Michael R. ; Chen, Heidi ; Fujimoto, Junya ; Moreira, Andre L. ; Ramalingam, Suresh S. ; Villaruz, Liza C. ; Otterson, Gregory A. ; Haura, Eric ; Politi, Katerina ; Glisson, Bonnie ; Cetnar, Jeremy ; Garon, Edward B. ; Schiller, Joan ; Waqar, Saiama N. ; Sequist, Lecia V. ; Brahmer, Julie ; Shyr, Yu ; Kugler, Kelly ; Wistuba, Ignacio I. ; Johnson, Bruce E. ; Minna, John D. ; Kris, Mark G. ; Bunn, Paul A. ; Kwiatkowski, David J. / The impact of smoking and tp53 mutations in lung adenocarcinoma patients with targetable mutations—the lung cancer mutation consortium (LCMC2). In: Clinical Cancer Research. 2018 ; Vol. 24, No. 5. pp. 1038-1047.
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AU - Aisner, Dara L.

AU - Sholl, Lynette M.

AU - Berry, Lynne D.

AU - Rossi, Michael R.

AU - Chen, Heidi

AU - Fujimoto, Junya

AU - Moreira, Andre L.

AU - Ramalingam, Suresh S.

AU - Villaruz, Liza C.

AU - Otterson, Gregory A.

AU - Haura, Eric

AU - Politi, Katerina

AU - Glisson, Bonnie

AU - Cetnar, Jeremy

AU - Garon, Edward B.

AU - Schiller, Joan

AU - Waqar, Saiama N.

AU - Sequist, Lecia V.

AU - Brahmer, Julie

AU - Shyr, Yu

AU - Kugler, Kelly

AU - Wistuba, Ignacio I.

AU - Johnson, Bruce E.

AU - Minna, John D.

AU - Kris, Mark G.

AU - Bunn, Paul A.

AU - Kwiatkowski, David J.

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N2 - Purpose: Multiplex genomic profiling is standard of care for patients with advanced lung adenocarcinomas. The Lung Cancer Mutation Consortium (LCMC) is a multi-institutional effort to identify and treat oncogenic driver events in patients with lung adenocarcinomas. Experimental Design: Sixteen U.S. institutions enrolled 1,367 patients with lung cancer in LCMC2; 904 were deemed eligible and had at least one of 14 cancer-related genes profiled using validated methods including genotyping, massively parallel sequencing, and IHC. Results: The use of targeted therapies in patients with EGFR, ERBB2, or BRAF p.V600E mutations, ALK, ROS1, or RET rearrangements, or MET amplification was associated with a survival increment of 1.5 years compared with those with such mutations not receiving targeted therapy, and 1.0 year compared with those lacking a targetable driver. Importantly, 60 patients with a history of smoking derived similar survival benefit from targeted therapy for alterations in EGFR/ALK/ ROS1, when compared with 75 never smokers with the same alterations. In addition, coexisting TP53 mutations were associated with shorter survival among patients with EGFR, ALK, or ROS1 alterations. Conclusion: Patients with adenocarcinoma of the lung and an oncogenic driver mutation treated with effective targeted therapy have a longer survival, regardless of prior smoking history. Molecular testing should be performed on all individuals with lung adenocarcinomas irrespective of clinical characteristics. Routine use of massively parallel sequencing enables detection of both targetable driver alterations and tumor suppressor gene and other alterations that have potential significance for therapy selection and as predictive markers for the efficacy of treatment.

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