NF1 mutations identify molecular and clinical subtypes of lung adenocarcinomas

Cancer Med. 2019 Aug;8(9):4330-4337. doi: 10.1002/cam4.2175. Epub 2019 Jun 14.


The tumor suppressor gene neurofibromin 1 (NF1) is a major regulator of the RAS-MAPK pathway. NF1 mutations occur in lung cancer but were not extensively explored. We hypothesized that NF1-mutated tumors could define a specific population with a distinct clinical and molecular profile. We performed NF1 sequencing using next generation sequencing (NGS) in 154 lung adenocarcinoma surgical specimens with known KRAS, EGFR, TP53, BRAF, HER2, and PIK3CA status, to evaluate the molecular and clinical specificities of NF1-mutated lung cancers. Clinical data were retrospectively collected, and their associations with molecular profiles assessed. In this series, 24 tumors were NF1 mutated (17.5%) and 11 were NF1 deleted (8%). There was no mutation hotspot. NF1 mutations were rarely associated with other RAS-MAPK pathway mutations. Most of patients with NF1 alterations were males (74.3%) and smokers (74.3%). Overall survival and disease-free survival were statistically better in patients with NF1 alterations (N = 34) than in patients with KRAS mutations (N = 30) in univariate analysis. Our results confirm that NF1 is frequently mutated and represents a distinct molecular and clinical subtype of lung adenocarcinoma.

Keywords: NF1; RAS-MAPK pathway; lung adenocarcinoma; molecular subtype; next generation sequencing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma of Lung / genetics
  • Adenocarcinoma of Lung / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • High-Throughput Nucleotide Sequencing / methods
  • Humans
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology*
  • MAP Kinase Signaling System
  • Male
  • Middle Aged
  • Mutation*
  • Neoplasm Staging
  • Neurofibromin 1 / genetics*
  • Prognosis
  • Retrospective Studies
  • Sequence Analysis, DNA
  • Sequence Deletion
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / genetics
  • Survival Analysis


  • NF1 protein, human
  • Neurofibromin 1