Genetic alterations in key oncogenes have been frequently identified in lung adenocarcinoma
(LUAD), including genes encoding epidermal growth factor receptor ( EGFR ), Kirsten
rat sarcoma viral oncogene homolog ( KRAS ), and anaplastic lymphoma kinase ( ALK
). In this pilot study, we aimed to characterize the differences in enriched biological
pathways and phosphorylation events between LUAD tumors harboring EGFR , KRAS , or
echinoderm microtubule‐associated protein‐like 4 ( EML4 )– ALK oncogenic alterations
and triple wild‐type LUAD tumors (WT, without EML4–ALK , KRAS , or EGFR alterations)
by mass spectrometry (MS)‐based quantitative proteomics and phosphoproteomics. We
analyzed tumor regions of 82 formalin‐fixed paraffin‐embedded (FFPE) tissue sections
with 6, 23, 31, and 22 samples from the EML4–ALK , EGFR , KRAS , and WT sample groups,
respectively. A total of 1377 to 2189 proteins and 73 to 1781 phosphosites were quantified
in these analyses. Based on the results, the samples clustered according to their
genetic alteration type, and EGFR ‐mutated samples showed unique protein expression
patterns. Membrane organization, vesicle organization, and vesicle‐mediated transport
Gene Ontology Biological Process (GOBP) terms were significantly downregulated in
EGFR ‐mutated samples compared to the other sample groups. Changes in 36 proteins
and 52 phosphosites were also identified as potentially specific to a given genetic
alteration. Many of these proteins have previously been linked to EGFR or KRAS mutations
[e.g., cathepsin L, stimulator of interferon genes protein (STING)], whereas several
phosphoproteins are associated with RNA splicing [e.g., serine/arginine‐rich splicing
factor 1 (SRSF1), SRSF2, and SRSF7 proteins]. Kinase–substrate enrichment analysis
indicated altered activities of 10 kinases, including mitogen‐activated protein kinases
(MAPKs) and cyclin‐dependent kinases (CDKs). For example, CDK2 activity was elevated
in EML4–ALK samples compared to the other sample groups. Our results could provide
significant insights into further studies that could contribute to developing improved
diagnostic and therapeutic strategies for LUAD.