HER2-mutated (HER2-M+) non-small cell lung cancer (NSCLC) represents a distinct molecular subtype with expanding therapeutic options including HER2 antibody-based therapies and tyrosine kinase inhibitors. We describe the molecular epidemiology and genomic features of HER2-M+ NSCLC in the setting of an Asian tertiary cancer centre.

The ADAURA study showed significant reduction in risk of disease recurrence/death with adjuvant osimertinib for Stage IB–IIIA resected EGFR-mutated NSCLC. However, due to early unblinding of the study coupled with paucity of data on patterns of relapse and absence of long-term survival data, the cost:benefit ratio of adjuvant osimertinib remains uncertain. We sought to determine molecular and clinical features that impact outcomes in early stage EGFR-mutated NSCLC.

Invasive mucinous adenocarcinoma (IMA) is an uncommon adenocarcinoma variant defined by goblet or columnar cells containing intracytoplasmic mucin and extensive extracellular mucin. Historically, IMAs have been associated with a poorer prognosis. However emerging evidence indicates a majority harbour potentially actionable driver oncogenes and IMA may be associated with downregulation of lung lineage-specifying transcription factor NKX2-1/TTF-1 resulting in a mid/hindgut phenotype. Morphologic features of IMA have also not been well characterised.

While the multi-factorial process that give rise to lung cancer is driven by exogenous carcinogens and inherited genetic changes, there is growing evidence that racial and ethnic differences also influence incidence, mortality and treatment response. Existing cancer genomics resources do not provide ethnic variability in the genomics of lung cancer, owing to data availability and the prohibitive computational costs in preparing available genomics data for analysis. For example, one state-of-the-art platform, cBioportal, maintains a large repository of pan-cancer data along with tools to carry out omics analysis, but lacks uniformly processed Asian lung cancer samples to enable cross-cohort comparisons.