Non-small cell lung cancer in the very young: Higher EGFR/ALK mutation proportion than the elder.
Journal
Journal of the Chinese Medical Association : JCMA
ISSN: 1728-7731
Titre abrégé: J Chin Med Assoc
Pays: Netherlands
ID NLM: 101174817
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
pubmed:
30
3
2020
medline:
30
10
2021
entrez:
30
3
2020
Statut:
ppublish
Résumé
This study aimed to analyze pathologic characteristics, treatment, prognosis, and tumor epidermal growth factor receptor/anaplastic large-cell lymphoma kinase (EGFR/ALK) mutation proportion of non-small cell lung cancer (NSCLC) patients aged <40 years at diagnosis. We retrospectively reviewed data of NSCLC patients diagnosed at Taipei Veterans General Hospital between June 2007 and December 2014, aged <90 years at the time of the diagnosis. We found 5051 cases of NSCLC, including 168 patients who were <40 years (younger group) and 4883 patients aged 40 to 89 years (older group). We found that the younger group had a significantly higher proportion of the EGFR mutation (22.6% vs 16.2%, p = 0.026) and the ALK mutation (4.2% vs 0.5%, p < 0.001) than the older group. Although the younger group included more stage IV patients (60.1% vs 49.6%, p = 0.002), it had a better overall survival (OS) rate (1 year: 73.7% vs 66.2%, p = 0.043; 5 years: 44.4% vs 33.7%, p = 0.004) (median survival time: 55 vs 26 months, p = 0.002). About the histologic subtype of NSCLC, the younger group presented less frequent cases of squamous cell carcinoma (4.2% vs 16.1%, p < 0.001), whereas the adenocarcinoma subtype was similarly frequent in the two groups (76.8% vs 76.5%, p = 0.924). The OS rate in younger NSCLC patients was higher than that in the older NSCLC patients, despite the higher rate of stage IV NSCLC patients in the younger group. This survival benefit is most likely due to the higher proportion of the EGFR and ALK mutations and the corresponding tyrosine kinase inhibitor treatment.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to analyze pathologic characteristics, treatment, prognosis, and tumor epidermal growth factor receptor/anaplastic large-cell lymphoma kinase (EGFR/ALK) mutation proportion of non-small cell lung cancer (NSCLC) patients aged <40 years at diagnosis.
METHODS
METHODS
We retrospectively reviewed data of NSCLC patients diagnosed at Taipei Veterans General Hospital between June 2007 and December 2014, aged <90 years at the time of the diagnosis.
RESULTS
RESULTS
We found 5051 cases of NSCLC, including 168 patients who were <40 years (younger group) and 4883 patients aged 40 to 89 years (older group). We found that the younger group had a significantly higher proportion of the EGFR mutation (22.6% vs 16.2%, p = 0.026) and the ALK mutation (4.2% vs 0.5%, p < 0.001) than the older group. Although the younger group included more stage IV patients (60.1% vs 49.6%, p = 0.002), it had a better overall survival (OS) rate (1 year: 73.7% vs 66.2%, p = 0.043; 5 years: 44.4% vs 33.7%, p = 0.004) (median survival time: 55 vs 26 months, p = 0.002). About the histologic subtype of NSCLC, the younger group presented less frequent cases of squamous cell carcinoma (4.2% vs 16.1%, p < 0.001), whereas the adenocarcinoma subtype was similarly frequent in the two groups (76.8% vs 76.5%, p = 0.924).
CONCLUSION
CONCLUSIONS
The OS rate in younger NSCLC patients was higher than that in the older NSCLC patients, despite the higher rate of stage IV NSCLC patients in the younger group. This survival benefit is most likely due to the higher proportion of the EGFR and ALK mutations and the corresponding tyrosine kinase inhibitor treatment.
Identifiants
pubmed: 32221155
doi: 10.1097/JCMA.0000000000000311
pii: 02118582-202005000-00009
doi:
Substances chimiques
ALK protein, human
EC 2.7.10.1
Anaplastic Lymphoma Kinase
EC 2.7.10.1
EGFR protein, human
EC 2.7.10.1
ErbB Receptors
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
461-465Références
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005; 55:74–108
Lara MS, Brunson A, Wun T, Tomlinson B, Qi L, Cress R, et al. Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC): a California Cancer Registry analysis. Lung Cancer. 2014; 85:264–9
Nugent WC, Edney MT, Hammerness PG, Dain BJ, Maurer LH, Rigas JR. Non-small cell lung cancer at the extremes of age: impact on diagnosis and treatment. Ann Thorac Surg. 1997; 63:193–7
Subramanian J, Morgensztern D, Goodgame B, Baggstrom MQ, Gao F, Piccirillo J, et al. Distinctive characteristics of non-small cell lung cancer (NSCLC) in the young: a surveillance, epidemiology, and end results (SEER) analysis. J Thorac Oncol. 2010; 5:23–8
Thomas A, Chen Y, Yu T, Jakopovic M, Giaccone G. Trends and characteristics of young non-small cell lung cancer patients in the United States. Front Oncol. 2015; 5:113
Kuo CW, Chen YM, Chao JY, Tsai CM, Perng RP. Non-small cell lung cancer in very young and very old patients. Chest. 2000; 117:354–7
Arnold BN, Thomas DC, Rosen JE, Salazar MC, Blasberg JD, Boffa DJ, et al. Lung cancer in the very young: treatment and survival in the National Cancer Data Base. J Thorac Oncol. 2016; 11:1121–31
Ramalingam S, Pawlish K, Gadgeel S, Demers R, Kalemkerian GP. Lung cancer in young patients: analysis of a surveillance, epidemiology, and end results database. J Clin Oncol. 1998; 16:651–767
Luis CR, Oscar A, Luis M, Báez-Saldaña R, Castillo-Fernández O, Blais N, et al. An international epidemiological analysis of young patients with non-small cell lung cancer (AduJov-CLICaP). Lung Cancer. 2017; 113:30–6
Arbour KC, Riely GJ. Systemic therapy for locally advanced and metastatic non-small cell lung cancer: a review. JAMA. 2019; 322:764–74
Tsai CM, Perng RP, Huang WL. Lung cancer in young Chinese. Cancer Detect Prev. 1988; 11:235–8
Capewell S, Wathen CG, Sankaran R, Sudlow MF. Lung cancer in young patients. Respir Med. 1992; 86:499–502
Bourke W, Milstein D, Giura R, Donghi M, Luisetti M, Rubin AH, et al. Lung cancer in young adults. Chest. 1992; 102:1723–9
Green LS, Fortoul TI, Ponciano G, Robles C, Rivero O. Bronchogenic cancer in patients under 40 years old. The experience of a Latin American country. Chest. 1993; 104:1477–81