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Article

The Clinically Actionable Molecular Profile of Early versus Late-Stage Non-Small Cell Lung Cancer, an Individual Age and Sex Propensity-Matched Pair Analysis

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Vancouver Coastal Health Research Institute, 7113-2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
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Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC V5Z 1M9, Canada
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Canexia Health Inc., 1-3661 West 4th Avenue, Vancouver, BC V6R 1P2, Canada
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BC Department of Medical Oncology, BC Cancer—Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada
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Centre for Health Evaluation and Outcome Sciences (CHEOS), 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
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Cancer Genetics & Genomic Laboratory, BC Cancer—Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada
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Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(4), 2630-2643; https://doi.org/10.3390/curroncol29040215
Received: 5 March 2022 / Revised: 29 March 2022 / Accepted: 8 April 2022 / Published: 11 April 2022
Background: Despite meticulous surgery for non-small cell lung cancer (NSCLC), relapse is as high as 70% at 5 years. Many institutions do not conduct reflexive molecular testing on early stage specimens, although targeted gene therapy may extend life by years in the event of recurrence. This ultimately delays definitive treatment with additional biopsy risking suboptimal tissue acquisition and quality for molecular testing. Objective: To compare molecular profiles of genetic alterations in early and late NSCLC to provide evidence that reflexive molecular testing provides clinically valuable information. Methods: A single-center propensity matched retrospective analysis was conducted using prospectively collected data. Adults with early and late-stage NSCLC had tissue subject to targeted panel-based NGS. Frequencies of putative drivers were compared, with 1:3 matching on the propensity score; p < 0.05 deemed statistically significant. Results: In total, 635 NSCLC patients underwent NGS (59 early, 576 late); 276 (43.5%) females; age 70.9 (±10.2) years; never smokers 140 (22.0%); 527 (83.0%) adenocarcinomas. Unadjusted frequencies of EGFR mutations were higher in the early cohort (30% vs. 18%). Following adjustment for sex and smoking status, similar frequencies for both early and late NSCLC were observed for variants in EGFR, KRAS, ALK, MET, and ROS1. Conclusion: The frequency of clinically actionable variants in early and late-stage NSCLC was found to be similar, providing evidence that molecular profiling should be performed on surgical specimens. This pre-determined profile is essential to avoid treatment delay for patients who will derive clinical benefit from targeted systemic therapy, in the high likelihood of subsequent relapse. View Full-Text
Keywords: lung cancer; next-generation sequencing; biomarker; targeted therapy lung cancer; next-generation sequencing; biomarker; targeted therapy
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MDPI and ACS Style

McGuire, A.L.; McConechy, M.K.; Melosky, B.L.; English, J.C.; Choi, J.J.; Peng, D.; Yee, J.; Furman, B.L.S.; Aguirre Hernandez, R.; Feijao, P.; Mulder, D.; Hughesman, C.; Yip, S. The Clinically Actionable Molecular Profile of Early versus Late-Stage Non-Small Cell Lung Cancer, an Individual Age and Sex Propensity-Matched Pair Analysis. Curr. Oncol. 2022, 29, 2630-2643. https://doi.org/10.3390/curroncol29040215

AMA Style

McGuire AL, McConechy MK, Melosky BL, English JC, Choi JJ, Peng D, Yee J, Furman BLS, Aguirre Hernandez R, Feijao P, Mulder D, Hughesman C, Yip S. The Clinically Actionable Molecular Profile of Early versus Late-Stage Non-Small Cell Lung Cancer, an Individual Age and Sex Propensity-Matched Pair Analysis. Current Oncology. 2022; 29(4):2630-2643. https://doi.org/10.3390/curroncol29040215

Chicago/Turabian Style

McGuire, Anna L., Melissa K. McConechy, Barb L. Melosky, John C. English, James J. Choi, Defen Peng, John Yee, Benjamin L. S. Furman, Rosalia Aguirre Hernandez, Pedro Feijao, David Mulder, Curtis Hughesman, and Stephen Yip. 2022. "The Clinically Actionable Molecular Profile of Early versus Late-Stage Non-Small Cell Lung Cancer, an Individual Age and Sex Propensity-Matched Pair Analysis" Current Oncology 29, no. 4: 2630-2643. https://doi.org/10.3390/curroncol29040215

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