EGFR Mutations, ROS1, and ALK Rearrangements in Iranian Non-Small Cell Lung Cancer Patients

Abstract

Background: Driver mutations, particularly in the epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and ROS1 genes, are prevalent in non-small cell lung cancer (NSCLC) and significantly influence patient outcomes. These mutations have become crucial biomarkers for targeted therapy, guiding treatment decisions and improving patient survival. Our study aims to evaluate the prevalence of EGFR mutations, ALK, and ROS1 gene rearrangements in a cohort of Iranian NSCLC patients and to investigate their association with patient characteristics.

Materials and Methods: Tissue samples from patients diagnosed with non-small cell lung cancer (NSCLC) were subjected to molecular analysis. EGFR mutations, ALK, and ROS1 gene rearrangements were assessed. Additionally, the correlation between these genetic alterations and patient demographics, including age and gender, was explored. Results: Driver mutations or rearrangements were detected in approximately one-third of NSCLC cases. EGFR mutations were the most common, occurring in 22.44% of patients. ALK and ROS1 rearrangements were identified in 8.18% and 2.11% of patients, respectively. The EGFR mutation frequency in patients younger than 36 years was 16%. In contrast, the mutation frequency in older patient cohorts ranged from 11% to 15%. Among EGFR mutations, exon 19 deletions (13.35%) and L858R point mutations (6.81%) were the most prevalent. Notably, exon 19 deletions were more frequent in female patients (27.92%) compared to male patients (9.90%). Conclusion: EGFR mutations were more prevalent than ALK and ROS1 rearrangements in our cohort. Exon 19 deletions and L858R point mutations were the most common EGFR mutations, with a higher frequency observed in female patients. These mutations are frequently associated with lung adenocarcinoma.