Outcomes Following Surgical Resection of Early-Stage Lung Adenocarcinomas with EGFR mutations

Abstract Background Routine mutation profiling for resected lung cancers is not widespread despite an increasing array of targeted therapies. We report the incidence of EGFR mutations (EGFRmu+) in resected lung adenocarcinomas and their outcomes at a large, North American cancer center to characterize this population now eligible for targeted adjuvant therapy. Methods Among 1036 pulmonary resections performed between 2015-2019, 647 (62%) patients had adenocarcinomas that underwent molecular profiling by next-generation sequencing. Clinical and pathologic characteristics, along with survival, were analyzed. Results EGFRmu+ were identified in 238 (37%) patients. Patients with EGFRmu+ were more likely to be Asian than those with EGFR wild-type (79/238 (33%) vs. 37/409 (9%), p Conclusions While Asian, never-smokers comprise a disproportionately large group of patients with lung adenocarcinomas with EGFRmu+, the majority of EGFR mutations within our cohort were found in patients who are white or with a smoking history, supporting a routine, rather than selective approach to mutation profiling. Patients with surgically resected stage IA and IB lung adenocarcinomas enjoy excellent survival regardless of their mutational status.