Clinical characteristics, molecular profiling, and survival outcomes of lung cancer patients: A 5-year retrospective study in Malaysia

Background: Lung cancer remains a leading cause of cancer-related mortality worldwide. In Malaysia, it ranks as the third most common cancer with a high proportion of late-stage diagnoses. Aims and Objectives: This study aimed to evaluate the clinical characteristics, molecular profiles, treatment strategies, and survival outcomes of lung cancer patients over a 5-year period in a private tertiary hospital. Materials and Methods: A retrospective cohort study was conducted at Beacon Hospital, Malaysia, involving patients diagnosed with pathologically confirmed primary lung cancer between January 2019 and December 2023. Demographic, clinical, and molecular data were extracted from medical records. Survival analysis was performed using the Kaplan–Meier method, focusing on patients with epidermal growth factor receptor (EGFR) mutations treated with tyrosine kinase inhibitors (TKIs). Results: A total of 470 patients were included, with 55.5% being male and the majority aged 60–74 years. Adenocarcinoma was the most common histological subtype (75.9%) and 80.2% of cases were diagnosed at stage IV. Molecular profiling revealed that 204 patients had EGFR mutations, predominantly exon 19 deletions and exon 21 (L858R). Among patients treated with EGFR TKIs, second-generation agents (afatinib and dacomitinib) demonstrated the longest median survival (39 months) and highest 5-year survival rate (95.1%), followed by third-generation TKIs (osimertinib; 83.3%) and first-generation TKIs (erlotinib and gefitinib; 64.7%). Conclusion: The findings highlight the predominance of advanced-stage lung cancer in Malaysia and underscore the critical role of molecular profiling in guiding targeted therapies. Second-generation EGFR TKIs were associated with the most favorable survival outcomes, supporting their use in real-world clinical settings. This study contributes to the limited body of local evidence and may inform future strategies to improve lung cancer management in Malaysia.