Clini Cancer Res: The SMARCA4 mutation predicts the prognosis in lung cancer patients.

!---- background: The SMARCA4 mutation is one of the most common recurrent variants in non-small cell lung cancer (NSCLC), but its relationship to other genomic abnormalities and clinical effects have not yet been determined.method: To summarize the characteristics of SMARCA4 mutations in NSCLC, Schoenfeld and others analyzed genomic, protein expression and clinical prognostic data for patients with SMARCA4 mutations treated at Caitlin Cancer Center.results: Of the 4,813 cancer patients, 407 (8%) were SMARCA4 mutant lung cancer.researchers divided the SMARCA4 mutation into two types: type 1 (cut-off mutation, fusion and purity deficiency) and type 2 mutation (wrong mutation).protein expression loss is associated with type 1 mutation (81% vs. 0%, p.lt;0.001).the two types of mutations appear more frequently in combination with KRAS, STK11, and KEAP1 mutations than SMARCA4 wild tumors (p-lt;0.001).in patients with metastatic NSCLC, SMARCA4 variants were associated with shorter patient survival, with type 1 variant associated with the shortest survival time (p-lt;0.002)., the researchers found that the treatment with immunocheckpoint inhibitors was associated with improved prognosis in patients with SMARCA4 mutant tumors (p.01), of which patients with type 1 mutation were the most responsive to ICIs (p-0.027).Conclusion: The SMARCA4 variant can be divided into two clinically relevant genomic categories, which are related to different levels of protein expression and different prognosis and therapeutic significance.both types of mutations can occur simultaneously with KEAP1, STK11 and KRAS mutations, and can independently indicate poor prognosis.is associated with adverse prognosis, SMARCA4 mutant lung cancer may be more sensitive to immunotherapy..