Investigation of clinicopathological and prognostic association of TERT promoter mutation in non-small cell lung cancer in a Turkish population

Onur Dülger; Ilhan Yaylim; Ismail Yilmaz; Fatma Sen; Büge Öz

doi:10.5114/pjp.2025.149380

eISSN: 2084-9869
ISSN: 1233-9687

Polish Journal of Pathology

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abstract:

Original paper

Investigation of clinicopathological and prognostic association of TERT promoter mutation in non-small cell lung cancer in a Turkish population

Onur Dülger

¹

,

Ilhan Yaylim

¹

,

Ismail Yilmaz

²

,

Fatma Sen

³

,

Büge Öz

⁴

Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
Department of Pathology, Abdulhamid Han Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
Department of Medical Oncology, Avrasya Hospital, Istanbul, Turkey
Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey

Pol J Pathol 2025; 76 (1):

DOI: https://doi.org/10.5114/pjp.2025.149380

Online publish date: 2025/04/09

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Non-small cell lung cancer (NSCLC) is characterized by a complex and heterogeneous molecular basis. Telomerase reverse transcriptase (TERT) gene promoter mutations have been implicated in various cancer types. We aimed to investigate the status of TERT promoter region mutations in NSCLCs and determine associations of clinicopathological connections, driver mutations, programmed death-ligand 1 (PD-L1) expression, and overall survival (OS) in the Turkish population.

The study included 186 patients diagnosed with NSCLC at a tertiary care center pathology department between 2017 and 2022. TERT promoter mutations were present in 2.7% and associated with old age (p = 0.015).

The levels of PD-L1 expression were higher in TERT mutants (p = 0.016). TERT mutants had shorter median OS than wild types (p = 0.006) and TERT mutation was an independent risk factor (p = 0.004). TERT and EGFR mutations may co-occur and be associated with shorter median OS in patients who continue to receive EGFR treatment (p < 0.001).

TERT promoter mutations were associated with high PD-L1 expression and adverse prognosis in NSCLC. In addition, they may play a major role in patients' poor clinical outcomes during EGFR therapy. In conclusion, TERT may be a significant parameter for future follow-up and treatment selection of NSCLC.

keywords:

Investigation of clinicopathological and prognostic association of TERT promoter mutation in non-small cell lung cancer in a Turkish population

Onur Dülger 1 , Ilhan Yaylim 1 , Ismail Yilmaz 2 , Fatma Sen 3 , Büge Öz 4

clinicopathological features, non-small cell lung cancer, prognosis, TERT mutation

Onur Dülger

¹

,

Ilhan Yaylim

¹

,

Ismail Yilmaz

²

,

Fatma Sen

³

,

Büge Öz

⁴