Prevalence of EGFR mutations in non-small cell lung cancer in Hawaii: A multi-center epidemiology study.

e22585 Background: Epidermal Growth Factor Receptor (EGFR) mutation analysis in non-small cell lung cancer (NSCLC) is crucial for navigating treatment decision-making and improving survival outcomes. EGFR mutations are more prevalent among Asian Americans at 38.8% as compared to 17.4% in whites (REF). Hawaii has the highest proportion of Asian Americans and Native Hawaiian/Pacific Islanders (NH/PI) in the USA. Among this diverse population of Asian Americans, Native Hawaiians, and Pacific Islanders, the . Here, we present an analysis of EGFR-mutated NSCLC across diverse patient populations in Hawaii. Methods: This study included patients aged 18 years and older diagnosed with NSCLC at Hawaii Pacific Health between January 1, 2021, and December 31, 2023, and at Queen’s Medical Center between July 1, 2016, and December 31, 2022, in Hawaii (n = 281). Clinical data, including sex, race and ethnicity (whites, Filipino, Japanese American, other Asian American, NH/PI, and Other ethnicities), smoking status, and histological subtypes were also collected. Fisher’s exact test was used to analyze associations between EGFR mutations and patient characteristics. Results: Among 1028 NSCLC patients screened, 281 patients were appropriate for EGFR testing based on stage, histology, and clinical characteristics, of which 126 patients (44.8%) were positive. Female, Never-smokers, and adenocarcinoma histology were significantly associated with a higher prevalence of EGFR mutations (54.2%, 68.5%, and 54.3%, respectively; p < 0.05). As compared to whites, EGFR mutations were significantly more prevalent among Filipinos (OR 3.45; 95% CI: 1.52–8.10; p = 0.01), Japanese Americans (OR 2.42; 95% CI: 1.02–5.90; p = 0.03), and other Asian (OR 2.70; 95% CI: 1.13–6.68; p = 0.01). The prevalence of EGFR mutations among NH/PI was 42.3 %. No significant differences in EGFR mutation prevalence were observed among NH/PI patients with unknown/other races as compared to whites. Conclusions: To our knowledge, this is the first study to investigate the prevalence of EGFR mutations among various race and ethnic groups in Hawaii. Novel findings include: Filipino NSCLC cases having the highest prevalence of EGFR mutations and defining the prevalence of EGFR mutations in the NH/PI population (42.3%). Additional studies will explore the association between EGFR-mutant NSCLC and survival outcomes in this unique Hawaiian population.