Impact of cigarette smoking and gender on EGFR mutation status in Iraqi lung cancer patients

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Background and aim Lung cancer, particularly NSCLC, is the foremost reason behind deaths associated with cancer globally and the second most prevalent malignancy among males in Iraq. Mutations in the EGFR gene are significant druggable targets in NSCLC, linked to sensitivity to tyrosine kinase inhibitors. This study aims to analyse the incidence and kinds of EGFR mutations in Iraqi NSCLC patients and their correlation with gender and smoking status, despite global data indicating that EGFR mutations are more prevalent in females and non-smokers. Materials and methods A retrospective analysis was conducted on 214 FFPET samples. Information regarding the patients’ gender and smoking history was documented. DNA was extracted use the NucleoSpin tissue kit, and EGFR mutations were identified employing the Cobas z 480 analyser. The prevalence and types of mutations were associated with gender and smoking status; a p -value below 0.05 was regarded as statistically significant. Results Among 214 NSCLC cases, 51 (23.8%) exhibited EGFR mutations, with 58.8% being male and 41.2% female. The exon 19 deletion, Exdel19, represented the highest prevalence in both males and females, constituting 70% and 71.4%, respectively. The smoking status exhibited a significant correlation with Exdel19 mutation status ( p = 0.048), indicating a considerably greater mutation rate among nonsmokers. Conclusion The results of this study demonstrated the influence of smoking on the occurrence of EGFR mutations, particularly Exdel19, in Iraqi lung cancer patients. Systematic evaluation of EGFR mutations, in conjunction with smoking reduction initiatives, will enhance results with targeted therapy and diminish the burden of lung cancer both locally and globally.

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