Abstract 1277P
Background
Young non-small cell lung cancer (NSCLC) patients under the age of 40 shows a low diagnosis rate and a low smoking rate with a more aggressive course and a poorer prognosis than the elderly. However, few studies have examined molecular alterations characteristics of this population. Here, we use next-generation sequencing (NGS) to compare the molecular variation spectrum differences between the young and the elderly.
Methods
A total of 73 young and 92 elderly NSCLC patients were enrolled. The FFPE (formalin fixed and paraffin embedded) surgical resection tissue samples were collected from 2014 to 2020 for NGS with a 1021-gene panel and the depth of 940×. The molecular variation landscapes of the youth and the elderly were compared. We also obtained 40 youth and 332 elderly NSCLC samples from the cBioportal database to verify our results.
Results
We found that the mutation rates of LRP1B、SMARCA4、STK11、FAT2、RBM10、FANCM genes in the elderly were significantly higher than in the youth. The mutation rates of EGFR 19DEL and 20INS in the young were higher than those in the elderly (16.4% vs 8.7%, 6.9% vs 1.1%), while the status of mutation rates of the L858R mutation was opposite (11.0% vs 22.8%). These results were consistent with data of public database. The frequency of EML4-ALK fusion was higher in the youth (11.0%) than in the elderly (2.2%). We also detected 9.6% BCL2L11 deletion (somatic) in the youth. Pyclone results show that EGFR mutations as the main clone in the young than in the elderly.
Conclusions
Compared with the elderly NSCLC, for the young NSCLC, the EGFR gene mutation was the main clone mutation with higher proportions of the 19DEL and 20INS, and a lower proportion of the L858R mutation. Besides, the ALK fusion variation was significantly higher in the young than that in the elderly. The intratumoral heterogeneity in the young was significantly lower than that in the elderly.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.