Abstract 574
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)
| Characteristics | N | % | Median (range) |
|---|---|---|---|
| Age (years) | 30 (19 – 35) | ||
| Sex Male Female | 25 14 | 64 36 | |
| Smoking status (n = 37) Never smoker Current smoker | 29 08 | 78 22 | |
| Symptom duration (months) | 2 (0.3 – 10) | ||
| Symptom Hemoptysis Weight loss | 12 08 | 31 21 | |
| Eastern Cooperative Oncology Group performance status PS 1 PS 2 PS 3 | 5 12 02 | 64 31 05 | |
| TNM Stage 2 3 4 | 02 05 32 | 05 13 82 | |
| Upfront treatment type, localized disease (n = 6) Chemoradiation Surgery + adjuvant chemotherapy | 04 02 | 67 33 | |
| Metastatic disease (n = 32) | |||
| No or involved organ metastasis Single Two Three Four Five | 11 11 05 03 02 | 34 34 16 10 06 | |
| Site of metastasis Lung/pleura Bone Brain Liver | 24 17 08 06 | 75 53 25 19 | |
| Treatment taken Yes No | 27 05 | 84 16 | |
| Molecular profile (n = 25) EGFR mutation ALK ROS1 | 05 10 01 | 20 40 04 | |
| Upfront treatment type (n = 27) Chemotherapy Chemotherapy f/b TKI Crizotinib Gefitinib | 16 04 04 03 | 59 15 15 11 | |
| Treatment response (n = 24) Partial response Stable disease Progressive disease | 16 05 03 | 67 21 12 | |
| 2nd line treatment (n = 08) Chemotherapy Tyrosine kinase inhibitors | 05 03 | 15 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.