Impact of country of birth on genetic testing of metastatic lung adenocarcinomas in France: African women exhibit a mutational spectrum more similar to Asians than to Caucasians

// Raphael Saffroy 1, 2 , Jean-François Morère 2, 3 , Nelly Bosselut 1, 2 , Pasquale F. Innominato 3, 4, 5, 6 , Jocelyne Hamelin 1, 2 , Jean Trédaniel 7 , Sophie Masse 8 , Véronique Dussaule-Duchatelle 9 , André Balaton 9, 10 , Pierre Validire 11 , Catherine Guettier 12 , Mohamed Bouchahda 3, 13 and Antoinette Lemoine 1, 2 1 AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France 2 INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France 3 AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France 4 INSERM UMR-935, Université Paris-Sud, Hôpital Paul Brousse, Villejuif, France 5 Cancer Chronotherapy Unit, Cancer Research Centre, Warwick Medical School, University of Warwick, Coventry, United Kingdom 6 Department of Oncology, Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom 7 Hôpital Saint Joseph, Department of Respiratory Medicine, Université Paris 5, Paris, France 8 Groupe Hospitalier Nord Essonne, Department of Pathology, Longjumeau, France 9 Hôpital Saint Joseph, Department of Pathology, Paris, France 10 ACP Bievres-les Ulis, Department of Pathology, Les Ulis, France 11 Institut Mutualiste Montsouris, Department of Pathology, Paris, France 12 AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Pathology, Platform Oncomolpath/INCa, Villejuif, France 13 Ramsay-GDS Clinique du Mousseau, Department of Medical Oncology, Evry, France Correspondence to: Antoinette Lemoine, email: antoinette.lemoine@aphp.fr Keywords: NSCLC, genetic testing, genotype, EGFR, ERBB2 Received: November 01, 2016 Accepted: January 09, 2017 Published: February 07, 2017 ABSTRACT Background: Limited data are available on the prevalence of oncogenic driver mutations in Caucasian populations, and especially in Europeans. Aim: To evaluate the targetable mutational spectra in unselected patients with lung adenocarcinoma in routine clinical practice from several French hospitals, using the same molecular platform. Patients and Methods: Samples from 2,219 consecutive patients with histologically-proven advanced lung adenocarcinoma were centrally analysed at a referenced and certified diagnostic platform in order to test for activating and resistance mutations in EGFR , KRAS , BRAF , ERBB2 and PI3KCA . Demographic and clinical features were retrieved from the medical charts. Multivariate binary logistic regression was used to determine the independent predictive factors for the occurrence of specific mutations, in the whole study population or in selected subgroups. Findings: The overall respective incidence of EGFR , KRAS , BRAF , ERBB2 and PI3KCA mutations was 10.5%, 0.9%, 25%, 1.5%, 2.1% and 1.4%, in our study sample including 87.4% white Caucasians, 10.8% Africans and 1.8% Asians; 60.6% men, 30.7% never smoker (median age: 68.3 years). Ethnicity was an independent predictor for EGFR, KRAS and ERBB2 gene abnormalities. In all cases, a significantly higher prevalence of targetable EGFR and ERBB2 , and a lower prevalence of resistance KRAS mutations were observed in African women as compared to African men or Caucasians. Conclusions: In real life conditions of routine genetic testing, we have identified subsets of patients with specific targetable activating somatic mutations according to ethnicity, who could preferentially benefit from anti- EGFR and anti- ERBB2 targeted therapies.