Author of

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  P09 - Health Services Research/Health Economics - Real World Outcomes (ID 121)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Health Services Research/Health Economics
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35078

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    P09.30 - A Clinical and Molecular Portrait of a Younger Population with Advanced Non-Small Cell Lung Cancer (ID 1270)

    00:00 - 00:00  |  Presenting Author(s): Sophie Stock-Martineau
    • Abstract
    • Slides

    Introduction
    

    A smaller proportion of patients with metastatic non-small cell lung cancer present at a young age. We explored whether there were significant differences in demographics, baseline characteristics, histology, molecular characteristics and treatment uptake in a younger population less than 55 years old compared to older patients.

    Methods
    

    With ethics approval, we reviewed retrospectively our cohort of all cases of de novo stage IIIB/IIIC/IV NSCLC seen in out-patient medical oncology consultation between 2009-2012, 2015-2017 and 2018, all combined. We compared demographics, baseline characteristics, histology, molecular characteristics and treatment uptake in a younger population less than 55 years old versus older patients. We also looked at differences in survival.

    Results
    

    In total, 1081 patients were included. Patients less than 55 years old (n=91) represented only 8.4% of the cohort. Male to female ratio was smaller in the younger patients. Younger patients were more likely to be ECOG 0/1 (14/55 vs 8/38%), never smokers (21 vs 9%), and have adenocarcinoma histology (80 vs 69%). More EGFR+ cases (24% vs 14%) and ALK cases (16 vs 3%) were seen in the younger population. Overall, 79% of younger patients received palliative systemic treatment versus 57% in the older population. The younger patients had improved overall survival compared to the older patients (11.1 vs 7.5 months, p=0.0002).

    

    Conclusion
    

    In our cohort, a very small proportion of patients were younger than 55 years old. Unsurprisingly, their presentations and tumor characteristics are different to the older population, with higher rates of oncogene-addicted cancers. This supports guidelines mandating molecular testing in all adenocarcinomas, especially in never smokers and young patients. The improved OS of the younger patients is probably multifactorial, partly driven by the presence of these targetable driver mutations, but also a fitter population more likely to receive treatment.

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