Thread by @StephenVLiu

#WCLC20 Summary of molecular epidemiology of Asian lung cancer at the opening plenary by @TakashiKohno2. There are many different genomic subtypes of lung cancer and huge geographic variation. Reminder though: phenotype does not guide testing. #LCSM @OncoAlert

#WCLC20 In the US, actionable genomic alterations more common in never-smokers but still occur at relevant rates in smokers (and smokers probably undertested). In Japan, very high rates of alterations (like EGFR) in both smokers and never-smokers. #LCSM @OncoAlert

#WCLC20 But why? Why are there so many cases of lung cancer in never-smokers in Asia? Unique exposures? HLA differences? Why adeno and not squamous? Important work that will impact screening and treatment but very early. Is there a similar link with Native American ancestry?

#WCLC20 There are more alterations beyond #EGFR of course and the ongoing LC-SCRUM will look at other alterations including #NRG1. Plans now to include other countries in Asia. Frankly - this needs to be a global effort. We need far greater understanding of these subsets. #LCSM

#WCLC One of the barriers is cost but perhaps that could be defrayed when done as part of large research efforts! Collaboration is critical to progress here.