title: Prevalence of EGFR and ALK Mutations in Lung Adenocarcinomas in the Levant Area - a Prospective Analysis
abstract: Background: A significant percentage of lung adenocarcinomas have a driver mutation. To date, there has been no
  assessment of the prevalence of such mutations in a Middle Eastern population. The present multicenter prospective
  study of formalin fixed paraffin embedded (FFPE) tissues from patients diagnosed with lung adenocarcinoma was
  performed to assess the prevalence of EGFR and ALK mutations in the Levant. Methods: Patients of Middle Eastern
  origin with lung adenocarcinomas at 10 sites in Lebanon, Jordan and Iraq were prospectively enrolled. Tumors were
  tested for EGFR by PCR and for EML4-ALK translocation by fluorescence in situ hybridization (FISH). Results: A
  total of 210 patients were enrolled, 139 (66.2%) males and 71 females (33.8%), with a mean age of 63.4 years. EGFR
  testing of 205 (97.6%) demonstrated the wild type in 173 (84.4%) and mutated forms in 32 (15.6%). Some 46.9% of
  EGFR positive patients were non-smokers and 62.5% were females as opposed to 22.4% and 33.8%, respectively,
  in the general population. As for the EML4-ALK translocation, testing in 157 (74.8%) cases gave negative results in
  154 (98.1%) , only 3 being positive (1.9%), 2 being females and 2 non-smokers.Conclusion: Our study established a
  15.6% EGFR mutation rate in lung adenocarcinomas with ALK translocation mutations in only 1.9%, as compared to
  a 15-20% and 5%, respectively, in the Western literature.
authors.affiliation: American University of Beirut Medical Center, Department of Internal Medicine PO Box: 11-0236, Riad El Solh, Beirut 1107 2020, Beirut- Lebanon. Email: at35@aub.edu.lb
authors.forename: Arafat
authors.initials: A
authors.lastname: Tfayli
authors.forename: Hind
authors.initials: H
authors.lastname: Rafei
authors.forename: Alain
authors.initials: A
authors.lastname: Mina
authors.forename: Maya
authors.initials: M
authors.lastname: Khalil
authors.forename: Najla
authors.initials: N
authors.lastname: Fakhreddin
authors.forename: Rami
authors.initials: R
authors.lastname: Mahfouz
authors.forename: Shadi
authors.initials: S
authors.lastname: Hamouri
authors.forename: Fadi
authors.initials: F
authors.lastname: Farhat
authors.forename: Ziad
authors.initials: Z
authors.lastname: Salem
authors.forename: Haifa
authors.initials: H
authors.lastname: Dbouk
authors.forename: Haider
authors.initials: H
authors.lastname: Rabee
authors.forename: Nagi
authors.initials: N
authors.lastname: Saghir
authors.forename: Ali
authors.initials: A
authors.lastname: Shamseddine
authors.forename: Jawad
authors.initials: J
authors.lastname: Makarem
authors.forename: Nizar
authors.initials: N
authors.lastname: Bitar
authors.forename: Anas
authors.initials: A
authors.lastname: Mougharbil
authors.forename: Hazem
authors.initials: H
authors.lastname: Assi
authors.forename: Sally
authors.initials: S
authors.lastname: Temraz
authors.forename: Deborah
authors.initials: D
authors.lastname: Mukherji
authors.forename: Ismail
authors.initials: I
authors.lastname: Matalka
authors.forename: Ghazi
authors.initials: G
authors.lastname: Zaatari
keywords: Lung adenocarcinoma; EGFR mutation; EML-ALK translocation; levant area