Fig. 5: The hypothesized mechanism of observed higher BRAF mutation rate and low EGFR mutation rate in super MPLCs. | npj Precision Oncology

Fig. 5: The hypothesized mechanism of observed higher BRAF mutation rate and low EGFR mutation rate in super MPLCs.

From: Super multiple primary lung cancers harbor high-frequency BRAF and low-frequency EGFR mutations in the MAPK pathway

Fig. 5

A Summary of the main phenomena found in this article: super MPLCs have significantly higher mutation frequency of BRAF and lower mutation frequency of EGFR than MPLCs with fewer lesions. B The hypothesized mechanism contains three parts: Firstly, through the convergent evolutionary mechanism of multiple primary cancers, mutations in each lesion are limited to the MAPK pathway containing EGFR and BRAF. Then, based on the theories of functional redundancy and synthetic lethality, the mutations of two driven genes, EGFR and BRAF, exhibit mutual exclusion. Third, because of the mechanism of concomitant tumor resistance, the lesion with EGFR mutations has higher invasiveness and will inhibit the growth of smaller lesions, and thus, lesions in the observed super MPLCs tend to keep with low invasiveness and with BRAF mutation rather than EGFR mutation.

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