{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:14:45Z","timestamp":1780492485023,"version":"3.54.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Egypt Natl Canc Inst"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Driver molecular aberrations, such as epidermal growth factor receptor (<jats:italic>EGFR<\/jats:italic>) mutation and anaplastic lymphoma kinase (<jats:italic>ALK<\/jats:italic>) gene rearrangement, play an important role in the oncogenesis and progression of non-squamous non-small-cell lung cancers (NSCLC). Therefore, this study aimed to detect the incidence of driver mutations among non-squamous NSCLC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and methods<\/jats:title>\n                <jats:p>This was a retrospective-prospective cohort study on 131 patients with non-squamous NSCLC. Data on age, smoking status, chest symptoms, method of lung cancer diagnosis, molecular testing, including <jats:italic>EGFR<\/jats:italic> mutations in formalin-fixed paraffin-embedded (FFPE) tumor tissue and serum circulating tumor DNA using next-generation sequencing and <jats:italic>ALK<\/jats:italic> gene rearrangement by FFPE tumor tissue, and follow-up data regarding treatment modalities and outcomes were collected.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The median age of the patients was 57\u00a0years (range: 32\u201379\u00a0years). Out of 131 patients, 97 were males (74%), and 90 (68.7%) were smokers. Among 128 patients tested, 16 (12.5%) had <jats:italic>EGFR<\/jats:italic> mutations detected with either technique by formalin-fixed paraffin-embedded (FFPE) tumor tissue or\/and serum circulating tumor DNA using next-generation sequencing, and 6 (4.7%) had <jats:italic>ALK<\/jats:italic> rearrangement by FFPE tumor tissue. The majority (62.6%) presented with metastatic disease. Among the 102 patients who received first-line systemic therapy, the objective response rate was 50.0% in mutated NSCLC versus 14.6% in non-mutated (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Among the eight mutated patients who received first-line tyrosine kinase inhibitors (TKIs), 7 patients achieved either complete response or partial response. Among the 22 mutated patients, the median overall survival was 3\u00a0months in those who did not receive targeted therapy versus not reached in those who received any type of targeted therapy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Screening patients with newly diagnosed non-squamous NSCLC for driver mutations is essential for major prognostic and therapeutic implications. Early administration of TKIs in mutated patients significantly improves disease outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43046-023-00167-2","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T10:28:53Z","timestamp":1680517733000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Molecular patterns of egyptian patients with non-squamous non-small-cell lung cancers: a clinicopathological study"],"prefix":"10.1186","volume":"35","author":[{"given":"Mohamed Said","family":"Ismail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay","family":"Kassem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Al-Husseiny","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5037-8357","authenticated-orcid":false,"given":"Fatma Elzahraa","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Shalaby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Magdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"issue":"5","key":"167_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233768","volume":"15","author":"T Wallrabenstein","year":"2020","unstructured":"Wallrabenstein T, Del Rio J, Templeton AJ, Buess M. Much has changed in the last decade except overall survival: A Swiss single center analysis of treatment and survival in patients with stage IV non-small cell lung cancer. PLoS ONE. 2020;15(5): e0233768.","journal-title":"PLoS ONE"},{"key":"167_CR2","doi-asserted-by":"publisher","first-page":"943","DOI":"10.2147\/CMAR.S187317","volume":"11","author":"T Lu","year":"2019","unstructured":"Lu T, Yang X, Huang Y, Zhao M, Li M, Ma K, Yin J, Zhan C, Wang Q. Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades. Cancer Management and Research. 2019;11:943\u201353.","journal-title":"Cancer Management and Research"},{"issue":"48","key":"167_CR3","doi-asserted-by":"publisher","first-page":"78985","DOI":"10.18632\/oncotarget.12587","volume":"7","author":"YL Zhang","year":"2016","unstructured":"Zhang YL, Yuan JQ, Wang KF, Fu XH, Han XR, Threapleton D, Yang ZY, Mao C, Tang JL. The prevalence of EGFR mutation in patients with non-small cell lung cancer: A systematic review and meta-analysis. Oncotarget. 2016;7(48):78985.","journal-title":"Oncotarget"},{"issue":"suppl_1","key":"167_CR4","doi-asserted-by":"publisher","first-page":"i3","DOI":"10.1093\/annonc\/mdx702","volume":"29","author":"WH Hsu","year":"2018","unstructured":"Hsu WH, Yang JH, Mok TS, Loong HH. Overview of current systemic management of EGFR-mutant NSCLC. Ann Oncol. 2018;29(suppl_1):i3-9.","journal-title":"Ann Oncol"},{"issue":"6","key":"167_CR5","doi-asserted-by":"publisher","first-page":"561","DOI":"10.4103\/0970-2113.168099","volume":"32","author":"R Kota","year":"2015","unstructured":"Kota R, Gundeti S, Gullipalli M, Linga VG, Maddali LS, Digumarti R. Prevalence and outcome of epidermal growth factor receptor mutations in non-squamous non-small cell lung cancer patients. Lung India. 2015;32(6):561.","journal-title":"Lung India"},{"issue":"3","key":"167_CR6","doi-asserted-by":"publisher","first-page":"288","DOI":"10.21037\/tlcr.2016.06.07","volume":"5","author":"C Zappa","year":"2016","unstructured":"Zappa C, Mousa SA. Non-small cell lung cancer: Current treatment and future advances. Transl Lung Cancer Res. 2016;5(3):288\u2013300.","journal-title":"Transl Lung Cancer Res"},{"issue":"3","key":"167_CR7","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s00432-020-03414-4","volume":"147","author":"E Nadler","year":"2021","unstructured":"Nadler E, Arondekar B, Aguilar KM, Zhou J, Chang J, Zhang X, Pawar V. Treatment patterns and clinical outcomes in patients with advanced non-small cell lung cancer initiating first-line treatment in the US community oncology setting: A real-world retrospective observational study. J Cancer Res Clin Oncol. 2021;147(3):671\u201390.","journal-title":"J Cancer Res Clin Oncol"},{"key":"167_CR8","unstructured":"QIAGEN group. therascreen EGFR RGQ PCR Kit Handbook. Hilden. 2019."},{"issue":"6","key":"167_CR9","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1002\/cam4.2869","volume":"9","author":"Q Deng","year":"2020","unstructured":"Deng Q, Fang Q, Sun H, Singh AP, Alexander M, Li S, Cheng H, Zhou S. Detection of plasma EGFR mutations for personalized treatment of lung cancer patients without pathologic diagnosis. Cancer Med. 2020;9(6):2085\u201395.","journal-title":"Cancer Med"},{"issue":"5","key":"167_CR10","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1007\/s00432-020-03166-1","volume":"146","author":"Y Liu","year":"2020","unstructured":"Liu Y, Wu S, Shi X, Liang Z, Zeng X. ALK detection in lung cancer: Identification of atypical and cryptic ALK rearrangements using an optimal algorithm. J Cancer Res Clin Oncol. 2020;146(5):1307\u201320.","journal-title":"J Cancer Res Clin Oncol"},{"key":"167_CR11","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.lungcan.2020.10.012","volume":"152","author":"F Griesinger","year":"2021","unstructured":"Griesinger F, Eberhardt W, Nusch A, Reiser M, Zahn MO, Maintz C, Bernhardt C, Losem C, Stenzinger A, Heukamp LC, B\u00fcttner R. Biomarker testing in non-small cell lung cancer in routine care: Analysis of the first 3,717 patients in the German prospective, observational, nation-wide CRISP Registry (AIO-TRK-0315). Lung Cancer. 2021;152:174\u201384.","journal-title":"Lung Cancer"},{"issue":"8","key":"167_CR12","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1097\/JTO.0b013e31818020eb","volume":"3","author":"DR Youlden","year":"2008","unstructured":"Youlden DR, Cramb SM, Baade PD. The International Epidemiology of Lung Cancer: Geographical distribution and secular trends. J Thorac Oncol. 2008;3(8):819\u201331.","journal-title":"J Thorac Oncol"},{"issue":"6","key":"167_CR13","first-page":"1099","volume":"39","author":"JG Kattan","year":"2015","unstructured":"Kattan JG, Haddad F, Kourie HR, Naderi S, Rassy M, El Karak FR, Ghosn M, Sader-Ghorra C. EGFR mutation incidence and characteristics in non-squamous lung carcinoma in the Lebanese population. J Clin Oncol. 2015;39(6):1099\u2013102.","journal-title":"J Clin Oncol"},{"issue":"1","key":"167_CR14","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4103\/JIPO.JIPO_22_18","volume":"2","author":"AR Jazieh","year":"2019","unstructured":"Jazieh AR, Bounedjar A, Al Dayel F, Fahem S, Tfayli A, Rasul K, Jaafar H, Jaloudi M, Al Fayea T, Al Maghrabi HQ, Bamefleh H. The study of druggable targets in nonsquamous non-small-cell lung cancer in the Middle East and North Africa. J Immunother Precision Oncol. 2019;2(1):4\u20137.","journal-title":"J Immunother Precision Oncol"},{"issue":"5","key":"167_CR15","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1111\/1759-7714.13777","volume":"12","author":"E Mascarenhas","year":"2021","unstructured":"Mascarenhas E, Gelatti AC, Ara\u00fajo LH, Baldotto C, Mathias C, Zukin M, Werutsky G, Pacheco P, Gomes R, de Castro Jr G, Cordeiro de Lima VC. Comprehensive genomic profiling of Brazilian non\u2010small cell lung cancer patients (GBOT 0118\/LACOG0418). Thoracic Cancer. 2021;12(5):580\u20137.","journal-title":"Thoracic Cancer"},{"issue":"5","key":"167_CR16","doi-asserted-by":"publisher","first-page":"497","DOI":"10.6004\/jnccn.2022.0025","volume":"20","author":"DS Ettinger","year":"2022","unstructured":"Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman JR, Bharat A, Bruno DS, Chang JY, Chirieac LR, D\u2019Amico TA, DeCamp M, Dilling TJ, Dowell J, Gettinger S, Grotz TE, Gubens MA, Hegde A, Lackner RP, Lanuti M, Lin J, Loo BW, Lovly CM, Maldonado F, Massarelli E, Morgensztern D, Ng T, Otterson GA, Pacheco JM, Patel SP, Riely GJ, Riess J, Schild SE, Shapiro TA, Singh AP, Stevenson J, Tam A, Tanvetyanon T, Yanagawa J, Yang SC, Yau E, Gregory K, Hughes M. Non-small cell lung cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Comprehensive Cancer Network. 2022;20(5):497\u2013530.","journal-title":"J Natl Comprehensive Cancer Network."},{"key":"167_CR17","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2020\/e1777","volume":"75","author":"E Cronemberger","year":"2020","unstructured":"Cronemberger E, Baldotto C, Marinho F, De Marchi P, Ara\u00fajo LH, Franke F, Salles P, Calabrich A, Almeida T, Custodio MG, Maria AS. Real-world molecular testing and treatment patterns in Brazilian patients with newly diagnosed locally advanced or metastatic NSCLC. Clinics. 2020;75: e1777.","journal-title":"Clinics"},{"issue":"5","key":"167_CR18","doi-asserted-by":"publisher","first-page":"e723","DOI":"10.1016\/j.cllc.2021.01.019","volume":"22","author":"BH Goulart","year":"2021","unstructured":"Goulart BH, Chennupati S, Fedorenko CR, Ramsey SD. Access to tyrosine kinase inhibitors and survival in patients with advanced EGFR+ and ALK+ positive non\u2013small-cell lung Cancer treated in the real-world. Clin Lung Cancer. 2021;22(5):e723\u201333.","journal-title":"Clin Lung Cancer"},{"issue":"2","key":"167_CR19","doi-asserted-by":"publisher","first-page":"e257","DOI":"10.1200\/OP.20.00117","volume":"17","author":"R Salgia","year":"2021","unstructured":"Salgia R, Mambetsariev I, Pharaon R, Fricke J, Baroz AR, Hozo I, Chen C, Koczywas M, Massarelli E, Reckamp K, Djulbegovic B. Evaluation of omics-based strategies for the Management of Advanced Lung Cancer. JCO Oncol Pract. 2021;17(2):e257\u201365.","journal-title":"JCO Oncol Pract"}],"container-title":["Journal of the Egyptian National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43046-023-00167-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43046-023-00167-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43046-023-00167-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T10:43:38Z","timestamp":1680518618000},"score":1,"resource":{"primary":{"URL":"https:\/\/jenci.springeropen.com\/articles\/10.1186\/s43046-023-00167-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,3]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["167"],"URL":"https:\/\/doi.org\/10.1186\/s43046-023-00167-2","relation":{},"ISSN":["2589-0409"],"issn-type":[{"value":"2589-0409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,3]]},"assertion":[{"value":"28 November 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Institutional Review Board of Cairo University, faculty of medicine (IRB No. MD-203\u20132019) and performed in accordance with the principles of the Declaration of Helsinki. Written informed consents were obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Nothing to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7"}}