Lung cancer in Morocco: EGFR and PIK3CA mutations as therapeutic targets and the lack of HER2 mutations

Lung cancer (LC) mutations in the epidermal growth factor receptor (EGFR), phosphoinositide 3-kinase catalytic subunit alpha (PIK3CA), and human epidermal growth factor receptor 2 (HER2) genes represent promising targets for personalized treatment strategies. This study aims to investigate the mutation profiles of these genes in Moroccan LC patients and examine their correlation with clinicopathological features. In this prospective study, LC specimens were collected from 60 patients. Mutations in specific regions of EGFR (exons 18 – 21), PIK3CA (exons 9 and 20), and HER2 (exon 20) were assessed using polymerase chain reaction and sequencing. Correlation with clinicopathological features was analyzed using Jamovi software. Overall, 25 patients (41.7%, 25/60) harbored mutations in EGFR, and five patients (8.3%, 5/60) had alterations in PIK3CA, while no mutation was found in HER2. Most EGFR mutations were located in exon 21 (19/27), and PIK3CA mutations were found in exons 9 and 20. Interestingly, 3.4% of cases exhibited co-occurring PIK3CA and EGFR mutations. EGFR mutations were observed across multiple histological types, whereas PIK3CA mutations were associated with adenocarcinoma and squamous cell carcinoma. No notable correlations were found between EGFR mutations and clinicopathological parameters, but a significant association between PIK3CA mutations and age was observed. The occurrence of EGFR and PIK3CA mutations highlights their potential as biomarkers for personalized LC therapy. The absence of HER2 mutations in this cohort warrants further investigation. These findings highlight the importance of expanding molecular profiling to identify additional actionable mutations for tailored treatment in LC patients.