Luis Corrales-Rodríguez1, Oscar Arrieta2, Luis Mas3, Renata Báez-Saldaña4, Omar Castillo-Fernández5, Normand Blais6, Claudio Martín7, Melissa Juárez8, Priyanka Khanna9, Allan Ramos-Esquivel10, Ludwing Bacon11, Leonardo Rojas12, Beatriz Wills13, George Oblitas14, María Angelina Pérez15, Mauricio Cuello16, Andrés Felipe Cardona17. 1. Medical Oncology, Hospital San Juan de Dios, San José, Costa Rica; Centro de Investigación y Manejo del Cancer - CIMCA, San José, Costa Rica. Electronic address: corrales@cimcacr.com. 2. Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), México City, Mexico. 3. Clinical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru. 4. Instituto Nacional de Enfermedades Respiratorias, Mexico DF, Mexico. 5. Department of Oncology, Instituto Oncológico Nacional Panamá, Panamá City, Panama. 6. Hôpital Notre Dame - CHUM, Montreal, Canada. 7. Medical Oncology Department, Thoracic Oncology Unit, Instituto Fleming, Buenos Aires, Argentina. 8. Medical Oncology, Hospital San Juan de Dios, San José, Costa Rica; Centro de Investigación y Manejo del Cancer - CIMCA, San José, Costa Rica. 9. Centro de Investigación y Manejo del Cancer - CIMCA, San José, Costa Rica. 10. Medical Oncology, Hospital San Juan de Dios, San José, Costa Rica. 11. Oncology Department, Hospital Roberto Calderón, Managua, Nicaragua. 12. Clinical Oncology Department, Centro Javeriano de Oncología, Hospital San Ignacio, Bogotá, Colombia; Internal Medicine Department, Pontificia Universidad Javeriana, Bogotá, Colombia. 13. Internal Medicine Department, Johns Hopkins University, Baltimore, United States. 14. Instituto Oncológico Luis Razetti, Caracas, Venezuela. 15. Unidad Oncológica Venezuela, Caracas, Venezuela. 16. Medical Oncology Department, UdeLAR, Montevideo, Uruguay. 17. Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Internal Medicine Department, Universidad el Bosque - Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Abstract
BACKGROUND: A proportion of patients with NSCLC is diagnosed at 40 years or younger. These patients tend to be never-smokers, usually present with stage IV adenocarcinoma, and have somatic genomic alterations. Few studies have documented and analyzed epidemiological characteristics of this population. MATERIALS AND METHODS: We performed an international epidemiological analysis of 389 young patients with NSCLC. Data was collected from centers participating in the Latin American Consortium for Lung Cancer Research (AduJov-CLICaP). Patients were identified and data was retrospectively collected from different Latin American countries and Canada (Argentina=6, Canada=19, Colombia=29, Costa Rica=9, Mexico=219, Nicaragua=2, Panama=19, Perú=76 and Venezuela=10). The period of study was from 2012 to 2017. Inclusion criteria were: age 40 years or less and a histologically confirmed NSCLC. Clinical data was obtained, and EGFR mutation status and EML4-ALK translocation were collected. RESULTS: NSCLC patients aged 40 years or less accounted for approximately 4% of the total NSCLC population. Female patients accounted for 54.5%, while median age was of 37 years. Adenocarcinoma accounted for 86.1% (n=335/389), 72.5% (n=282/389; unknown=5) of patients were non-smokers, and 90.3% (n=351/389) had stage IV disease. Site of metastasis was obtained from 260/351 (unknown=91) stage IV patients (lung metastasis=40.0%, CNS metastasis=35.7%, and bone metastasis=31.5%). OS for the total population was 17.3 months (95%CI=13.9-20.7). OS for EGFRm(+)=31.4months (95%CI=11.6-51.3), EGFRm(-)=14.5months (95%CI=11.0-17.9) (p=0.005). OS for alk(+)=9.8months (95%CI=3.1-16.5) and alk(-)=5.6months (95%CI=3.9-7.3) (p=0.315). CONCLUSIONS: Patients aged 40 years or less account for a small but important proportion of NSCLC cases. Younger patients may have different characteristics compared to the older population. EGFRm and EML4-alk translocation frequency is higher than that of the general population.
BACKGROUND: A proportion of patients with NSCLC is diagnosed at 40 years or younger. These patients tend to be never-smokers, usually present with stage IV adenocarcinoma, and have somatic genomic alterations. Few studies have documented and analyzed epidemiological characteristics of this population. MATERIALS AND METHODS: We performed an international epidemiological analysis of 389 young patients with NSCLC. Data was collected from centers participating in the Latin American Consortium for Lung Cancer Research (AduJov-CLICaP). Patients were identified and data was retrospectively collected from different Latin American countries and Canada (Argentina=6, Canada=19, Colombia=29, Costa Rica=9, Mexico=219, Nicaragua=2, Panama=19, Perú=76 and Venezuela=10). The period of study was from 2012 to 2017. Inclusion criteria were: age 40 years or less and a histologically confirmed NSCLC. Clinical data was obtained, and EGFR mutation status and EML4-ALK translocation were collected. RESULTS:NSCLCpatients aged 40 years or less accounted for approximately 4% of the total NSCLC population. Female patients accounted for 54.5%, while median age was of 37 years. Adenocarcinoma accounted for 86.1% (n=335/389), 72.5% (n=282/389; unknown=5) of patients were non-smokers, and 90.3% (n=351/389) had stage IV disease. Site of metastasis was obtained from 260/351 (unknown=91) stage IV patients (lung metastasis=40.0%, CNS metastasis=35.7%, and bone metastasis=31.5%). OS for the total population was 17.3 months (95%CI=13.9-20.7). OS for EGFRm(+)=31.4months (95%CI=11.6-51.3), EGFRm(-)=14.5months (95%CI=11.0-17.9) (p=0.005). OS for alk(+)=9.8months (95%CI=3.1-16.5) and alk(-)=5.6months (95%CI=3.9-7.3) (p=0.315). CONCLUSIONS:Patients aged 40 years or less account for a small but important proportion of NSCLC cases. Younger patients may have different characteristics compared to the older population. EGFRm and EML4-alk translocation frequency is higher than that of the general population.