2022 World Conference on Lung Cancer (ePosters)-EP11.03-003. Adenocarcinoma Grade Correlates with PD-L1 and TP53, but not EGFR/KRAS Status and Diagnostic Yield: Analysis of 346 Cases

EP11.03-003. Adenocarcinoma Grade Correlates with PD-L1 and TP53, but not EGFR/KRAS Status and Diagnostic Yield: Analysis of 346 Cases

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A study conducted on 339 cases of resected primary lung adenocarcinoma aimed to analyze the correlation between adenocarcinoma grade and molecular profiles. The majority of non-mucinous adenocarcinoma cases were grade 3. The study found a higher proportion of current and ex-smokers compared to previous studies and a bias towards early-stage cases. The correlation between grade and PD-L1 and TP53 expression, as well as EGFR/KRAS status, was investigated. Limited evidence of common genomic alterations and PD-L1 expression across grades was found. Higher frequency of EGFR mutations in grade 2 tumors and KRAS mutations in grade 3 tumors were suggested in recent studies. The study used targeted hybrid DNA/RNA next-generation sequencing and immunohistochemistry for biomarker testing. Statistical analysis was performed.<br /><br />The study found that grade 3 tumors had higher PD-L1 expression and were more likely to have TP53 mutations. Mutational frequencies of EGFR and KRAS did not differ significantly across different grades. Non-mucinous adenocarcinoma had a higher molecular diagnostic yield compared to other subtypes. Grade 3 tumors were associated with advanced stage and male sex. Minor high-grade patterns did not predict TP53 mutation in grade 2 tumors.<br /><br />The study concluded that grade 3 tumors are more likely to require adjuvant therapy and have TP53 mutations, supporting the use of universal reflex molecular testing for resected primary adenocarcinoma. Risk-based priority testing and logistic factors should be considered in developing future diagnostic and management strategies.<br /><br />The study also compared mutational frequencies of EGFR and KRAS in resection versus biopsy samples and found no significant difference for EGFR mutations, but KRAS mutations were more commonly detected in resected tumors.

Asset Subtitle

Yu Zhi Zhang

Meta Tag

Speaker Yu Zhi Zhang

Topic Pathology - Tumour Biology

Keywords

lung adenocarcinoma

adenocarcinoma grade

molecular profiles

non-mucinous adenocarcinoma

smokers

early-stage cases

PD-L1 expression

TP53 mutations

EGFR mutations

KRAS mutations