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P1.01 - Poster Session with Presenters Present (ID 453)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
P1.01-016 - An International Epidemiological Analysis of Young Patients Diagnosed with NSCLC (AduJov - CLICaP) (ID 6296)
14:30 - 15:45 | Author(s): L. Corrales-Rodriguez
Eventhough lung cancer remains a disease of a median age at diagnosis of 70y, a proportion of patients are diagnosed at 40y or younger. Patients diagnosed before the age of 40 tend to be never-smokers, are stage IV adenocarcinoma, and tend to have an EGFR activating mutation or a EML4-alk translocation. It is crucial to determine the epidemiological characteristics of patients younger than 40y. Our study groups the largest population of patients less than 40y diagnosed with NSCLC.
In this epidemiological retrospective study, 249 patients (Argentina=6, Canada=19, Colombia=29, Costa Rica=9, Mexico=89, Nicaragua=2, Panama=19, and Peru=76) with a histologically confirmed NSCLC aged 40 years or less at diagnosis were included. Data included age, gender, histology, stage, EGFR and alk mutation analysis, and date of death or last follow-up. Progression free survival (PFS) and overall survival (OS) were also recorded.
NSCLC patients aged 40 years or less accounted around a 4% of the total NSCLC population. Median age was 34.5 years (range 14-40), 137 (55%) were women, and 192 patients (77.1%) were non-smokers. Adenocarcinoma was the most frequent histological subtype with 203 patients (81.6%) and 24 patients (9.6%) were squamous. 214 patients (85.9%) were stage IV and 23 patients (9.2%) were stage III at diagnosis. The site(s) of metastasis was obtained in 203/214 stage IV patients where 39.9% (n=81) had lung, 35.6% (n=72) had SNC, and 31.7% (n=64) had bone metastasis. EGFR mutation (EGFRm) analysis was determined in 103 patients with 40 patients (38.8%) having an EGFRm. EML4-alk analysis was determined in 165 patients with 11 patients having a positive translocation (6.7%). The OS for all patients was 14.4 months (95%CI=11.2-17.6), PFS was 5.7 months (95%CI=4.9-6.5), and there was no significant difference according to histological subtype. OS for EGFRm(+) was 42 months (95%CI=30.8-54.0) and for EGFRm(-) was 19.4 months (95%CI=14.8-24.0) (p=0.002); PFS for EGFRm(+) was 11.9 months (95%CI=6.3-17.5) and for EGFRm (-) was 7.1 months (95%CI=5.3-8.9) (p=0.005). OS for alk(+) was 28.0 months (95%CI=15.4-40.6) and for alk(-) was 10.6 months (95%CI=6.9-14.3) (p=0.065).
NSCLC patients aged 40 years or less constitute a small but important proportion of patients with this diagnosis. Other risk factors may be involved in the pathogenesis of the disease in this population due to a low smoking history found. SNC metastasis at diagnosis seems to be more frequent in this population. EGFR mutation and EML4-alk translocation frequency is higher than the frequency reported in the general population.