The regional diversity of the genomics of non–small cell lung cancer (NSCLC) is an intriguing topic. Yet, little is known about the baseline factors—either genetic or environmental—that lead to different patterns of NSCLC-related mutations, except for tobacco-associated carcinogens. In a recent publication by Carrot-Zhang and colleagues (1), the authors presented very interesting data on patients from Colombia and Mexico and highlighted a plausible relationship between Native American genetic ancestry and somatic mutations in EGFR.

The authors concluded “that while controlling for global ancestry, local ancestry is associated with mutations in EGFR and KRAS, providing the first example, to our knowledge, of a germline influence” for targetable somatic events in lung cancer (1). To further the community discussion of this important topic we would like to highlight and discuss some prior evidence that also points in this direction. In a study of 444 lung adenocarcinomas...

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