A clinicopathological and molecular profiling study of <i>EGFR</i> mutations in a cohort of 215 lung cancer patients from Eastern India.

Abstract

e20708 Background: Epidermal Growth Factor Receptor (EGFR) mutations are a critical biomarker in non-small cell lung cancer (NSCLC), guiding targeted therapy decisions. While global prevalence and patterns are well-documented, regional variations influenced by genetic, environmental, and lifestyle factors necessitate localized studies. This study aimed to characterize the prevalence, patterns, and clinicopathological correlations of EGFR mutations in a lung cancer cohort from Eastern India. Methods: This observational study analyzed 215 lung cancer patients. Formalin-fixed paraffin-embedded (FFPE) tissues or blood samples were collected. DNA was extracted, and EGFR mutation analysis was performed using real-time PCR (TRUPCR EGFR kit). Clinicopathological data, including age, sex, smoking history, histology, and survival, were collected. Statistical analyses were performed using MS Excel and Friedman’s ANOVA. Survival analysis was conducted using Kaplan-Meier plots. Results: EGFR mutations were identified in 38% of patients. Exon 19 deletions were the most common mutation (39% of mutated cases). Mutations were more frequent in patients aged &gt;60 years (62%), males (25% of total cohort), smokers, and those with adenocarcinoma. A significant proportion of mutated cases were found in smokers (52%) and passive smokers (24%). Systemic inflammatory markers (NLR, PLR) showed variations across exon mutation types. Survival analysis revealed a statistically significant improvement in survival for patients with any EGFR exon mutation compared to wild-type (p=0.019). No significant survival differences were observed based on sex, age, histology, or smoking status. Conclusions: This study confirms the high prevalence of EGFR mutations in an Eastern Indian cohort, aligning with global trends in demographic and histological associations. However, the notable frequency of mutations among smokers and the significant survival advantage associated with any exon mutation highlight potential region-specific characteristics. These findings underscore the importance of universal EGFR testing for all NSCLC patients in this region, irrespective of smoking history, to optimize access to targeted therapies.