Lung Cancer in Adolescent & Young Adults: Single Center Experience from Eastern India

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancers in Adolescents and Young Adults (AYA)
Thoracic Malignancies
Presenter Bivas Biswas
Citation Annals of Oncology (2018) 29 (suppl_9): ix150-ix169. 10.1093/annonc/mdy425
Authors B. Biswas, D. Dabkara, S. Ganguly, J. Ghosh
  • Medical Oncology, Tata Medical Center, 700160 - Kolkata/IN

Abstract

Background

Lung cancer is the most common cancer and cancer related death amongst male in India. There is paucity of data about AYA lung cancer epidemiology and treatment outcome in India. Here, we have analyzed demography, molecular features and treatment outcome in AYA lung cancer patients treated at our center.

Methods

This is a single institutional review of patients aged 10 to 35 years treated between Oct’13 and Feb’18 with diagnosis of Lung cancer. Those with diagnosis of squamous cell carcinoma (SCC) and adenocarcinoma were analyzed for demographic feature, clinico-pathological characteristics whereas treatment outcome and survival analysis was done in patients with advanced disease who received treatment.

Results

Total 48 patients were registered with median age of 30 years (range: 10-35). Histology was – neuroendocrine tumor in 6 (13%), mucoepidermoid carcinoma in 3 (6%), SCC in 4 (8%) and adenocarcinoma in 35 (73%) patients. Baseline features are outlined in the table. Thirty-two (82%) patients had metastasis on diagnosis and 40% (n = 10) patients had ALK-rearranged adenocarcinoma. After median follow-up of 9.6 months (range: 1.1-56.2), median progression-free survival (PFS) was 14.4 months (95 CI: 6.2-35) and median overall survival (OS) was 31.6 months (95 CI: 8.2 – not reached). Median PFS was 8.7 months & 35.5 months whereas median OS was 17.9 months & 56.2 months in patients treated with chemotherapy (n = 16) and with tyrosine kinase-inhibitor (n = 11), respectively. Median PFS was 35.5, 14.4 & 6.2 months whereas median OS was 56.2, not reached & 8.9 months in patients treated with EGFR mutation (n = 5), ALK-rearrangement (n = 9) and molecular negative (n = 11) tumors, respectively.Table: 544P

Baseline characteristics and treatment details (n = 39)

CharacteristicsN%Median (range)
Age (years)30 (19 – 35)
Sex Male Female25 1464 36
Smoking status (n = 37) Never smoker Current smoker29 0878 22
Symptom duration (months)2 (0.3 – 10)
Symptom Hemoptysis Weight loss12 0831 21
Eastern Cooperative Oncology Group performance status PS 1 PS 2 PS 35 12 0264 31 05
TNM Stage 2 3 402 05 3205 13 82
Upfront treatment type, localized disease (n = 6) Chemoradiation Surgery + adjuvant chemotherapy04 0267 33
Metastatic disease (n = 32)
No or involved organ metastasis Single Two Three Four Five11 11 05 03 0234 34 16 10 06
Site of metastasis Lung/pleura Bone Brain Liver24 17 08 0675 53 25 19
Treatment taken Yes No27 0584 16
Molecular profile (n = 25) EGFR mutation ALK ROS105 10 0120 40 04
Upfront treatment type (n = 27) Chemotherapy Chemotherapy f/b TKI Crizotinib Gefitinib16 04 04 0359 15 15 11
Treatment response (n = 24) Partial response Stable disease Progressive disease16 05 0367 21 12
2nd line treatment (n = 08) Chemotherapy Tyrosine kinase inhibitors05 0315 23

Conclusions

Adenocarcinoma was the predominant histology and ALK-rearrangement was very high (40%) in our AYA lung cancer cohort, and majority (82%) had advanced disease on diagnosis. Outcome was excellent with molecular targeted therapy.

Editorial acknowledgement

not applicable

Clinical trial identification

not applicable

Legal entity responsible for the study

Department of Medical Oncology, Tata Medical Center, Kolkata, India.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.