ArticleTherapeutic advances in medical oncology2026
Clinically relevant somatic variants and genomic discordance between primary tumors and mediastinal lymph nodes in lung adenocarcinoma.
Article in Therapeutic advances in medical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Abstract
Background: Histopathological evaluation, TNM classification, and mediastinal staging via endobronchial ultrasound-guided transbronchial needle aspiration provide essential guidance for therapeutic decision-making in non-small cell lung cancer (NSCLC). Genomic profiles of primary tumors (PT) and matched mediastinal lymph nodes (MLN) can uncover occult metastases, refine recurrence risk assessment, and support personalized treatment strategies in lung adenocarcinoma (LUAD). Objectives: The study aimed to investigate clinically relevant somatic variants in formalin-fixed, paraffin-embedded (FFPE) PT and scrapings of MLN cytological slide samples using next-generation sequencing (NGS) and correlated the findings with overall survival (OS). Design: We retrospectively analyzed the genomic profile of PT and MLN from Brazilian LUAD patients between 2013 and 2020. Methods: Genomic DNA (gDNA) was extracted from PT and MLN matched samples of 32 patients ( Results: Clinically significant or potentially significant variants were identified in 72% of PT and 75% of MLN, totaling 46 and 51 variants, respectively. The most frequent variants in PT involved Conclusion: Cox regression analysis demonstrated that the presence of co-mutations in MLN was a co-factor associated with poorer OS, while no significant associations were observed for PT variants. These findings highlight distinct genomic profiles between PT and MLN. Integrating the molecular profile of MLN into staging may improve prognostic accuracy and guide treatment decisions in LUAD patients.
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