# Genomic landscape of lung adenocarcinoma in East Asians

Source: https://onco.cc/key-papers/paper-chen-east-asian-lung-adenocarcinoma-nat-genet-2020/  
OnCo record `paper-chen-east-asian-lung-adenocarcinoma-nat-genet-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Sequencing 305 lung adenocarcinomas from East Asian patients showed that the same cancer in a different population has a calmer genome, far more of the one mutation that has a good pill, and an immune-rich subgroup that nobody had described.

## Summary

A genomic and transcriptomic dataset of 305 lung adenocarcinomas from individuals of East Asian ancestry was assembled and compared with European-ancestry cohorts. East Asian tumours had more stable genomes, with fewer mutations and fewer copy-number alterations, and the difference was much stronger in smokers than in non-smokers. Transcriptomic clustering identified an East Asian-specific subgroup with a less complex genomic profile and upregulated immune-related genes, raising the possibility of immunotherapy-based approaches. Integrative analysis across clinical and molecular features showed the importance of molecular phenotypes in prognostic stratification, and prediction accuracy was better in the East Asian cohort than in the European-ancestry one, potentially because of the simpler genomic architecture.

## Fields

- Kind: Key paper
- Last checked: 2026-09-25
- Journal: Nature Genetics
- Year: 2020
- DOI: 10.1038/s41588-019-0569-6
- Authors: Chen J, Yang H, Teo ASM, et al.
- Findings: East Asian lung adenocarcinomas carry fewer mutations and fewer copy-number alterations than European-ancestry tumours.; The ancestry difference is much larger among smokers.; A new East Asian subgroup with a simple genome and high immune gene expression.; EGFR is mutated in 143 of 302 sequenced tumours, 47.4%, against 12.4% in the TCGA series.
- What it means: It shows that the driver frequencies quoted in Western guidelines are population statistics rather than facts about the disease, which matters for how many patients anywhere are expected to benefit from a given medicine.
- Caveats: A single-country cohort, so East Asian is a coarse label for several populations.; Smoking history is self-reported.; Prognostic models built on one ancestry have not been validated prospectively in another.

## Sources

- Chen et al., Nat Genet 2020: the genomic landscape of lung adenocarcinoma in 305 East Asians (OncoSG): https://doi.org/10.1038/s41588-019-0569-6
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32015526/
- cBioPortal study luad_oncosg_2020 (OncoSG, Nat Genet 2020; 305 East Asian lung adenocarcinomas, 302 sequenced): https://www.cbioportal.org/study/summary?id=luad_oncosg_2020

## Connected records

- cancers: [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [RNA sequencing & expression profiling](https://onco.cc/technologies/rna-seq/), [Whole-exome & whole-genome sequencing](https://onco.cc/technologies/wes-wgs/)
- targets: [EGFR](https://onco.cc/targets/egfr/), [HER2](https://onco.cc/targets/her2/), [KEAP1](https://onco.cc/targets/keap1/), [KRAS](https://onco.cc/targets/kras/), [STK11](https://onco.cc/targets/stk11/), [TP53](https://onco.cc/targets/tp53/)
- institutions: [National Cancer Centre Singapore](https://onco.cc/institutions/nccs/)
- pathways: [Mutagenesis & mutational signatures](https://onco.cc/pathways/mutagenesis-signatures/), [Non-small cell lung cancer (KEGG map)](https://onco.cc/pathways/nsclc-signalling/), [Receptor tyrosine kinase activation](https://onco.cc/pathways/rtk-activation/)
- terms: [Copy number alteration (CNA)](https://onco.cc/terms/copy-number-variation-term/), [Driver mutation](https://onco.cc/terms/driver-mutation/), [EGFR mutation subtypes (exon 19 deletion, L858R, exon 20 insertion, T790M)](https://onco.cc/terms/egfr-mutation-subtypes/)
- journals: [Nature Genetics](https://onco.cc/journals/nature-genetics/)
- biomarkers: [EGFR exon 19 deletion](https://onco.cc/biomarkers/egfr-exon-19-deletion/), [EGFR L858R](https://onco.cc/biomarkers/egfr-l858r/)

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