Clinical and molecular characterization of a large Brazilian lung cancer cohort: a real-world observational study.
[BACKGROUND] Driver alterations influence lung cancer management and vary among ethnicities.
- p-value p < 0.0001
- p-value p = 0.003
- 95% CI 1.43-2.90
- OR 2.04
- HR 1.38
APA
de Oliveira Cavagna R, Escremim de Paula F, et al. (2026). Clinical and molecular characterization of a large Brazilian lung cancer cohort: a real-world observational study.. Lancet regional health. Americas, 56, 101429. https://doi.org/10.1016/j.lana.2026.101429
MLA
de Oliveira Cavagna R, et al.. "Clinical and molecular characterization of a large Brazilian lung cancer cohort: a real-world observational study.." Lancet regional health. Americas, vol. 56, 2026, pp. 101429.
PMID
41815386
Abstract
[BACKGROUND] Driver alterations influence lung cancer management and vary among ethnicities. Patients from Latin America remain underrepresented in genomic studies. We characterized the molecular and ancestry profiles of Brazilian patients with lung cancer using real-world data and evaluated associations with clinicopathological features.
[METHODS] We retrospectively analyzed 1131 patients with lung cancer from a referral center, using DNA/RNA-based Next-generation Sequencing (NGS), immunohistochemistry, and ancestry-informative markers to assess molecular profiles and associate them with clinical features.
[FINDINGS] Oncogenic alterations were detected in 988 (88%) of patients, mainly at [656 (58%)], (K) [289 (25.6%)], and [228 (20.6%)] genes. mutations were associated with former smoking (OR: 2.04, 95% CI: 1.43-2.90), current smoking (OR: 3.79, 95% CI: 2.65-5.41), central nervous system (CNS) metastases (OR: 1.75, 95% CI: 1.18-2.58), and higher African ancestry (OR: 1.53, 95% CI: 1.08-2.18). mutations were associated with former smoking (OR: 6.47, 95% CI: 3.59-11.68) and current smoking (OR: 7.42, 4.13-13.31). mutations were associated with never smoking (OR: 12.87, 95% CI 7.12-23.2). Worse cancer-specific survival was observed among patients who currently smoke (HR: 1.38, 95% CI: 1.07-1.78), with poor performance status (HR: 1.99, 1.64-2.41), and those with CNS metastases (HR: 6.38, 4.80-8.47). In patients with mutations, treatment with chemotherapy was associated with longer survival (15.0 . 2.0 months; log-rank p < 0.0001). In the subset of patients harboring mutations and treated with targeted inhibitors, co-mutations were associated with shorter cancer-specific survival (24.0 . 61.0 months; log-rank p = 0.003).
[INTERPRETATION] Most Brazilian patients with lung cancer harbor actionable genomic alterations. status is prognostically relevant, including in the -mutant disease, and should be routinely incorporated. It provides region-specific evidence to inform equitable access to molecular diagnostics and targeted therapies in Latin America.
[FUNDING] Public Ministry of Labor Campinas (Research, Prevention, and Education of Occupational Cancer-15th zone, Campinas, Brazil), PRONON-PRONON/MS (Abordagens móveis e de tecnologia para prevenção primária e secundária de câncer-NUP: 25000.015000/2019-53), and Barretos Cancer Hospital.
[METHODS] We retrospectively analyzed 1131 patients with lung cancer from a referral center, using DNA/RNA-based Next-generation Sequencing (NGS), immunohistochemistry, and ancestry-informative markers to assess molecular profiles and associate them with clinical features.
[FINDINGS] Oncogenic alterations were detected in 988 (88%) of patients, mainly at [656 (58%)], (K) [289 (25.6%)], and [228 (20.6%)] genes. mutations were associated with former smoking (OR: 2.04, 95% CI: 1.43-2.90), current smoking (OR: 3.79, 95% CI: 2.65-5.41), central nervous system (CNS) metastases (OR: 1.75, 95% CI: 1.18-2.58), and higher African ancestry (OR: 1.53, 95% CI: 1.08-2.18). mutations were associated with former smoking (OR: 6.47, 95% CI: 3.59-11.68) and current smoking (OR: 7.42, 4.13-13.31). mutations were associated with never smoking (OR: 12.87, 95% CI 7.12-23.2). Worse cancer-specific survival was observed among patients who currently smoke (HR: 1.38, 95% CI: 1.07-1.78), with poor performance status (HR: 1.99, 1.64-2.41), and those with CNS metastases (HR: 6.38, 4.80-8.47). In patients with mutations, treatment with chemotherapy was associated with longer survival (15.0 . 2.0 months; log-rank p < 0.0001). In the subset of patients harboring mutations and treated with targeted inhibitors, co-mutations were associated with shorter cancer-specific survival (24.0 . 61.0 months; log-rank p = 0.003).
[INTERPRETATION] Most Brazilian patients with lung cancer harbor actionable genomic alterations. status is prognostically relevant, including in the -mutant disease, and should be routinely incorporated. It provides region-specific evidence to inform equitable access to molecular diagnostics and targeted therapies in Latin America.
[FUNDING] Public Ministry of Labor Campinas (Research, Prevention, and Education of Occupational Cancer-15th zone, Campinas, Brazil), PRONON-PRONON/MS (Abordagens móveis e de tecnologia para prevenção primária e secundária de câncer-NUP: 25000.015000/2019-53), and Barretos Cancer Hospital.