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Lung cancer is the deadliest cancer worldwide. The mutational frequency of  EGFR  and  KRAS  genes in lung adenocarcinoma varies worldwide per ethnicity and smoking. The impact of  EGFR  and  KRAS  mutations in Brazilian lung cancer remains poorly explored. Thus, we investigated the frequency of  EGFR  and  KRAS  mutations in a large Brazilian series of lung adenocarcinoma together with patients’ genetic ancestry, clinicopathological and sociodemographic characteristics. The mutational frequency of  EGFR  was 22.7% and  KRAS  was 20.4%. The average ancestry proportions were 73.1% for EUR, 13.1% for AFR, 6.5% for AME and 7.3% for ASN.  EGFR  mutations were independently associated with never-smokers, high-Asian ancestry, and better performance status.  KRAS  mutations were independently associated with tobacco exposure and non-Asian ancestry.  EGFR -exon 20 mutations were associated with worse outcome. The Cox regression model indicated a worse outcome for patients whose were older at diagnosis (>61 y), solid histological subtype, loss of weight (>10%), worse performance status (≥2), and presence of  KRAS  mutations and  EGFR  mutational status in TKi non-treated patients. In conclusion, we assessed the clinicopathological and ethnic impact of  EGFR  and  KRAS  mutations in the largest series reported of Brazilian lung adenocarcinomas. These findings can support future clinical strategies for Brazilian lung cancer patients.

scientific reports

Mutational profile of Brazilian lung adenocarcinoma unveils association of EGFR mutations with high Asian ancestry and independent prognostic role of KRAS mutations