Erkam KOCAASLAN, Pinar ATA, Emir GOCER, Firat AKAGUNDUZ, Ahmet DEMIREL, Mustafa Alperen TUNC, Ali Kaan GUREN, Burak PACACI, Yesim AGYOL, Pinar EREL, Osman KOSTEK, Ibrahim Vedat BAYOGLU
Marmara Medical Journal - 2026;39(3):202-208
Objective: To determine the frequency and distribution of genomic alterations detected by plasma-based next-generation sequencing (NGS) in metastatic lung adenocarcinoma in a real-world setting. Patients and Methods: This retrospective single-center study included 76 patients with histologically confirmed metastatic lung adenocarcinoma who underwent plasma circulating tumor DNA (ctDNA) NGS between March 2021 and July 2024. Targeted sequencing was performed using a 28-gene panel. Genomic alterations were classified as actionable according to current clinical guidelines. Concordance with available tissue-based molecular testing was evaluated in the internal cohort. Results: At least one genomic alteration was detected in 43/76 patients (56.6%). Among NGS-positive patients, 19/43 (44.2%) had >=2 alterations. Actionable alterations were identified in 24/76 patients (31.6%;55.8% of NGS-positive cases). The most frequently altered genes were TP53 (35.5%), EGFR (18.4%), and KRAS (13.2%). In an exploratory survival analysis of internal NGS-positive patients (n=19), median overall survival (OS) was 27 vs 29 months for patients with and without actionable alterations, respectively (p=0.94). Conclusion: Plasma-based NGS identifies clinically relevant genomic alterations in metastatic lung adenocarcinoma and complements tissue-based molecular testing in routine practice.
