Distribution of and Mutations in Patients with Surgically Resected Non-Small Cell Lung Cancer from Southern Italy: Real-Life Data from a Single Institution and Literature Review.

Background/objectives: The identification of driver mutations in NSCLC such as those in the and genes has revolutionized the understanding and management of many lung cancer patients and has opened up a new scenario in the early disease stages in terms of therapeutic options (EGFR) and prognosis (KRAS). Data on prevalence rates and disease stage distributions of and mutations in surgically resected NSCLC are growing, but in Southern Italy, estimation is limited, since upfront testing in early-stage adenocarcinoma has been only recently introduced according to the current guidelines in clinical practice, whereas screening is usually uninvestigated in resected NSCLC. In this real-life study of a single institution in the Apulia Region, we provide an overview of the epidemiological distribution of and mutations in patients in Southern Italy with resected NSCLC, highlighting their prevalence, clinical significance, and correlation with demographic and pathological factors. A literature review was also performed to compare our findings with the most recent available data from the screening of Italian cohorts of advanced and surgically resected NSCLC patients.

Methods: Data from 149 patients coming from Southern Italy with surgically resected NSCLC were retrospectively collected over a period of 16 years. and mutation screenings were performed and correlated with clinical and pathological data.

Results: In total, 24 out of 149 NSCLC (16%) patients harbored an mutation. Exon 19 deletions and missense p.L858R mutations of the gene have quite similar frequencies (46%) and were more observed in never smokers ( < 0.001) and female ( < 0.001) patients with the adenocarcinoma histotype. gene mutations were detected in 31.5% of cases, with missense p.G12C (32%), p.G12V (28%), and p.G12D (17%) mutations as the most frequent ones. Neither nor mutational status were found to impact overall survival (OS) in our study cohort.

Conclusions: Our findings improve the understanding of lung cancer genetics in a small and homogeneous area of Southern Italy and guide future research. The and mutations in NSCLC resected patients from Southern Italy showed a global similar incidence compared to other recently described Italian cohorts of advanced and early-stage NSCLC, with a higher frequency of exon19 deletions. No prognostic impact was observed for both and status, but additional investigations on a larger cohort are needed.