title: Role of race in oncogenic driver prevalence and outcomes in lung adenocarcinoma: Results from the Lung Cancer Mutation Consortium.
abstract: BACKGROUND
  The discovery of oncogenic drivers has ushered in a new era for lung cancer, but the role of these mutations in different racial/ethnic minorities has been understudied. The Lung Cancer Mutation Consortium 1 (LCMC1) database was investigated to evaluate the frequency and impact of oncogenic drivers in lung adenocarcinomas in the racial/ethnic minority patient population.
  
  
  METHODS
  Patients with metastatic lung adenocarcinomas from 14 US sites were enrolled in the LCMC1. Tumor samples were collected from 2009 through 2012 with multiplex genotyping performed on 10 oncogenic drivers (KRAS, epidermal growth factor receptor [EGFR], anaplastic lymphoma kinase (ALK) rearrangements, ERBB2 [formerly human epidermal growth factor receptor 2], BRAF, PIK3CA, MET amplification, NRAS, MEK1, and AKT1). Patients were classified as white, Asian, African American (AA), or Latino. The driver mutation frequency, the treatments, and the survival from diagnosis were determined.
  
  
  RESULTS
  One thousand seven patients were included. Whites represented the majority (n = 838); there were 60 AAs, 48 Asians, and 28 Latinos. Asian patients had the highest rate of oncogenic drivers with 81% (n = 39), and they were followed by Latinos with 68% (n = 19), whites with 61% (n = 511), and AAs with 53% (n = 32). For AAs, the EGFR mutation frequency was 22%, the KRAS frequency was 17%, and the ALK frequency was 4%. Asian patients were most likely to receive targeted therapies (51% vs 27% for AAs). There were no significant differences in overall survival.
  
  
  CONCLUSIONS
  Differences were observed in the prevalence of oncogenic drivers in lung adenocarcinomas and in subsequent treatments among racial groups. The lowest frequency of drivers was seen for AA patients; however, more than half of AA patients had a driver, and those treated with targeted therapy had outcomes similar to those of other races. Cancer 2016;122:766-772. © 2015 American Cancer Society.
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Conor E
authors.initials: CE
authors.lastname: Steuer
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Madhusmita
authors.initials: M
authors.lastname: Behera
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Lynne
authors.initials: L
authors.lastname: Berry
authors.affiliation: Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Sungjin
authors.initials: S
authors.lastname: Kim
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Michael
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sica
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Taofeek K
authors.initials: TK
authors.lastname: Owonikoko
authors.affiliation: Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Johnson
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kris
authors.affiliation: University of Colorado Cancer Center, Aurora, Colorado.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Bunn
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Fadlo R
authors.initials: FR
authors.lastname: Khuri
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Garon
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Suresh S
authors.initials: SS
authors.lastname: Ramalingam
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000235:genetics; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D001213:Asian / Q000235:genetics; D001932:Brain Neoplasms / Q000208:ethnology / Q000235:genetics* / Q000556:secondary; D058534:Class I Phosphatidylinositol 3-Kinases; D066246:ErbB Receptors / Q000235:genetics; D005006:Ethnicity / Q000235:genetics*; D005260:Female; D020558:GTP Phosphohydrolases / Q000235:genetics; D006630:Hispanic or Latino / Q000235:genetics; D006801:Humans; D008113:Liver Neoplasms / Q000208:ethnology / Q000235:genetics* / Q000556:secondary; D008175:Lung Neoplasms / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D048369:MAP Kinase Kinase 1 / Q000235:genetics; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D051057:Proto-Oncogene Proteins c-akt / Q000235:genetics; D019859:Proto-Oncogene Proteins c-met / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D014481:United States; D044465:White People / Q000235:genetics; D055815:Young Adult
chemical_list: D000077548:Anaplastic Lymphoma Kinase; D058534:Class I Phosphatidylinositol 3-Kinases; D066246:ErbB Receptors; D020558:GTP Phosphohydrolases; D048369:MAP Kinase Kinase 1; D008565:Membrane Proteins; D019869:Phosphatidylinositol 3-Kinases; D048493:Proto-Oncogene Proteins B-raf; D051057:Proto-Oncogene Proteins c-akt; D019859:Proto-Oncogene Proteins c-met; D016283:Proto-Oncogene Proteins p21(ras); D020794:Receptor Protein-Tyrosine Kinases; D018719:Erb-b2 Receptor Tyrosine Kinases; C117307:KRAS protein, human; C484760:PIK3CA protein, human; C000626173:ALK protein, human; C512478:EGFR protein, human; C508053:ERBB2 protein, human; C491743:MET protein, human; C494918:AKT1 protein, human; C482119:BRAF protein, human; C482125:MAP2K1 protein, human; C579846:NRAS protein, human
keywords: disparities; genomics; lung cancer; race; targeted therapy