High prevalence of gene abnormalities in young patients with lung cancer

Osamu Nagashima, Rina Ohashi, Yasuko Yoshioka, Ai Inagaki, Manabu Tajima, Yoshika Koinuma, Shin-ichiro Iwakami, Akihiko Iwase, Shinichi Sasaki, Shigeru Tominaga, Kazuhisa Takahashi


Background: Recently, driver oncogenes in adenocarcinoma of the lung were identified, and several molecular target agents were introduced in the clinical setting. However, there are few reports on the frequency of gene abnormalities in young patients with lung cancer.
Materials and methods: Twelve patients with lung adenocarcinoma aged 40 or younger at Juntendo University Urayasu Hospital or Juntendo University Hospital from July 2004 to March 2010 were analyzed for driver oncogene status including EGFR activating mutation, EML4-ALK fusion gene, and K-ras mutation.
Results: Four patients showed EGFR gene mutation. Five out of 7 EGFR mutation-negative patients showed positive results for EML4-ALK gene fusion. One case whose EGFR mutation was indeterminate.
Conclusions: Driver oncogene including EGFR mutation and EML4-ALK fusion gene was identified in 9 of 12 cases (75%). Examination of gene abnormalities is essential in young patients with non-small cell lung cancer to provide the best treatment.