By Lin Chia-nan / Staff reporter

A team of researchers yesterday unveiled the key genetic mutations of nonsmoking lung cancer patients, aiming to develop early diagnostic tools and precision medicine for the disease.

The study was a product of Taiwans participation in the US-led National Cancer Moonshot program since 2016, when Academia Sinica signed a memorandum of understanding with the US National Cancer Institute, Institute of Chemistry director Chen Yu-ju () told a news conference in Taipei.

While nearly 80 percent of lung adenocarcinoma patients in the US are chain smokers, more than half of the patients in Taiwan are nonsmokers, she said, adding that 93 percent of female patients do not smoke.

Photo: Chang Chia-ming, Taipei Times

It is a feature shared by many other East Asian countries, but the reason was unclear, she said, adding that the study was the first in East Asia to unravel the mystery.

Along with the US Clinical Proteomic Tumor Analysis Consortium, they studied tumor progression of patients in Taiwan and the US, she said.

Both studies were published in the journal Cell on Thursday last week and featured on its cover, showing an image of stargazers looking at a constellation that represents cancerous growth.

In Taiwan, up to 74 percent of female never-smokers (younger than 60 years old) showed higher mutation signatures of APOBEC a family of proteins related to RNA editing, Chen said.

The team also identified a correlation between high APOBEC signatures and good responses to immunotherapy treatment, making APOBEC a potential biomarker for early diagnosis, she added.

Some environmental carcinogens might be drivers in early carcinogenesis, as indicated by the teams findings about the metabolism and detoxification of carcinogens in females older than 70, Chen said.

Through the study, the team hopes to raise public awareness of the potential carcinogenesis of food additives, such as nitrosamine, which is used in fermented tofu and preserved radish, nitrated polycyclic aromatic hydrocarbons (nitro-PAHs) found in vehicle exhaust, cooking and secondhand smoke, as well as hereditary factors, Chen said.

As lung cancer symptoms mostly appear in late stages, most people have limited options other than immunotherapy and chemical therapy, which are costly, said National Taiwan University Hospital Division of Thoracic Surgery head Chen Jin-shing (), who provided clinical samples for the study.

The study helps with the development of screening tools through blood testing, which would allow high-risk groups for lung cancer to avoid carcinogenic substances or behaviors, he said.

The study is the first phenomenal outcome of Taiwans Cancer Moonshot, with more expected to come, said former vice president Chen Chien-jen (), now a distinguished research fellow at the institutions Genomics Research Center.

However, the program has only received four years of funding, which is to end next year, Chen Yu-ru said.

The funding has shrunk annually, she added, while expressing the hope that the government would continue to support the program.

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Study reveals key genetic mutations of nonsmokers -