Clinicopathologic characteristics and outcomes of Chinese patients with non-small-cell lung cancer and BRAF mutation

Abstract

BRAF mutation is one of the important driver oncogene in non-small-cell lung cancer (NSCLC). Data on Chinese patients with BRAF-mutant NSCLC are inadequate. Hence, we conducted this study to investigate the clinicopathologic features and outcomes of Chinese patients with NSCLC and BRAF mutations. We identified patients with BRAF-mutant NSCLC between January 2012 and April 2016. Patient characteristics and treatment outcomes were analyzed. In total, 1680 patients were included. Twenty-eight (1.7%) patients harbored BRAF mutations. Compared to patients with non-BRAF mutation, patients with BRAF mutations were associated with adenocarcinomas (89.3% vs. 70.6%, P = 0.048) and never smokers (78.6% vs. 56.7%, P = 0.019). There were no significant differences in the age, gender distribution, metastasis, or stage at first diagnosis between two groups. Response rates and progression-free survival (PFS) were similar between patient with BRAF mutations and EGFR (5.6 vs. 5.8 months; P = 0.277) or KRAS (5.6 vs. 4.7 months; P = 0.741) mutations to first-line chemotherapy. Compared to patients with non-V600E mutations, patients with V600E-mutated tumors had a shorter PFS to first-line chemotherapy, although this did not reach statistical significance (5.2 vs. 6.4 months; P = 0.561). In multivariate analyses, only ECOG PS remained the independent predictor of overall survival (HR = 0.208; P = 0.004). In conclusion, BRAF mutation in Chinese patients with NSCLC was rare. BRAF mutation is more likely to be associated with adenocarcinoma and never smokers. BRAF mutations are not associated with enhanced chemosensitivity and novel and effective drugs inhibiting the BRAF pathway are in urgent need.

Our study was arguably the first large-scale retrospective study to investigate the clinicopathologic features and outcomes of Chinese patients with BRAF-mutant NSCLC. We identified BRAF mutations in 1.7% of Chinese patients with NSCLC. BRAF mutation is associated with adenocarcinoma, and BRAF V600E mutation is more likely in never smokers. BRAF mutations are not associated with enhanced chemosensitivity.

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