2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.06G.10 Comprehensive Analysis of the Clinicopathological Features, Targetable Profle, and Prognosis of Mucinous Adenocarcinoma of the Lung

EP.06G.10 Comprehensive Analysis of the Clinicopathological Features, Targetable Profle, and Prognosis of Mucinous Adenocarcinoma of the Lung

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The comprehensive analysis detailed in this study examines the clinicopathological features, genetic profile, and prognosis of mucinous adenocarcinoma of the lung, a variant introduced in the 2015 WHO classification. This variant is distinct from non-mucinous adenocarcinoma and characterized by specific clinicopathological and genetic differences. <br /><br />Key findings from the study indicate that mucinous adenocarcinomas frequently exhibit KRAS mutations, particularly G12D, G12V, and G12C mutations, and occasionally NRG1 fusions, with a reported 51.7% having KRAS mutations. The study highlights the use of the multikinase inhibitor Afatinib as a possible treatment targeting NRG1 fusion. Computed Tomography (CT) images suggest solitary and pneumonic types, with pneumonic type associated with poorer prognosis.<br /><br />Data from Hiroshima University Hospital, covering cases between 1997 and 2018, indicate that approximately 17% of the mucinous adenocarcinoma cases had targetable mutations or fusions. However, due to low PD-L1 expression, anti-PD-1/PD-L1 inhibitors appear ineffective, particularly in invasive forms where pneumonic type and KRAS mutations correlate with poorer outcomes. Surgical outcomes show variations by type: solitary types often result in better prognoses absent recurrence, while pneumonic types correlate with higher risks of recurrence and poorer survival.<br /><br />Multivariate analysis identifies the pneumonic radiological feature and KRAS mutation status as independent poorer variables for recurrence-free survival and overall survival. The study underscores the importance of understanding these genetic and pathological nuances to refine prognosis and treatment strategies for mucinous adenocarcinoma, given their influence on patient survival outcomes. Non-invasive types (AIS, MIA) tend to present as solitary type lesions, where prognosis is typically better.

Asset Subtitle

Daisuke Ueda

Meta Tag

Speaker Daisuke Ueda

Topic Pathology and Biomarkers

Keywords

mucinous adenocarcinoma

lung cancer

clinicopathological features

genetic profile

KRAS mutations

NRG1 fusions

Afatinib treatment

Computed Tomography

prognosis

Hiroshima University Hospital