Genomic characteristics of driver genes in Chinese patients with non‐small cell lung cancer

BACKGROUND: The aim of this study was to determine the demographic profile of driver gene alterations, especially low‐frequency gene alterations in Chinese patients with non‐small cell lung cancer (NSCLC). METHODS: A total of 7395 Chinese patients with NSCLC were enrolled in the study. Next‐generation sequencing (NGS) was performed on formalin‐fixed paraffin‐embedded specimens collected via either surgical resection or biopsy. RESULTS: The frequent genomic alterations found in the study were EGFR mutations (51.7%), KRAS mutations (13.1%), MET alterations (5.6%; 3.2% copy number gains and 0.5% exon 14 skipping mutation), HER2 alterations (7.0%; 2.0% copy number gains and 5.4% mutations), ALK alterations (7.2%; 3.9% rearrangements), RET rearrangements (1.4%), ROS1 rearrangements (0.9%), and NTRK rearrangements (0.6%). The EGFR mutation rate was found to be significantly higher in women than in men (69.1% vs. 38.5%, P < 0.001), while the KRAS mutation (17.5% vs. 7.3%, P < 0.001) and MET alteration rates (6.5% vs. 4.5%, P < 0.001) were significantly higher in men than in women. The EGFR mutation rate tended to decrease with age in the group aged >40 years, while the KRAS mutation rate tended to increase with age. The HER2 mutation (13.9% vs. 6.7%, P < 0.001) and ALK alteration rates (14.3% vs. 6.9%, P < 0.001) were significantly higher in the group aged <40 years than in groups aged 40 years or older. CONCLUSIONS: The frequency of different driver genes was diverse in different age‐gender groups, and the results of this study may assist clinicians in clinical decision‐making and the development of public healthcare strategies in the future. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This study demonstrated that the frequency of different driver genes was diverse in different age‐gender groups. What this study adds: It may enable clinicians to make clinical decisions, and assist government, pharmaceutical researchers and insurance companies develop public healthcare strategies.