1228P - Association between air pollution and frequency of driver mutation among a Hispanic population with lung cancer

Background

Lung cancer (LC) ranks second in overall cancer mortality in Colombia. Air pollution (AP) has been previously associated with LC.

Methods

We conducted a retrospective cohort study of LC patients (PTS) diagnosed between 2015-2022 in Bogotá. Mean annual AP levels (PM2.5, PM10, SO2, CO, and NO2) were collected from the District Health Department across 12 locations for the five-year period preceding diagnosis. Univariate analyses assessed the link between driver mutations and air pollutants. Logistic regression models evaluated AP on EGFR, ALK, and PDL-1 status, adjusting for age, sex, and smoking history.

Results

Among 1,034 LC pts, molecular data was available for 221 (20%) PTS. The median age at diagnosis was 69-yo (IQR: 17), 57.5% (N=127) males, and 60.63% (N=134) had stage IV LC at diagnosis, 71.04% (N=157) had NSCLC. 26.2% (N=58) had EGFRmt, 11.3% had ALK translocations (N=25), and 44.8% (N=99) had PD-L1 ≥1%. On bivariate analysis, younger age (< 69-yo) was significantly correlated with EGFRmt. Higher levels of PM2.5 (EGFRmt 16.28 μg/m³, vs. EGRFwt 36.39 μg/m³; p=0.04 IQR=3.35), SO2 (EGFRmt 3.99 ppm [IQR=2.81] vs. EGRFwt 1.69 ppm [IQR=2.9; p<0.01]) and NO2 (EGFRmt 28.57 ppm [IQR=7.01] vs. EGRFwt 25.1 ppm [IQR=4.43; p=0.02]) were observed in EGFRmt pts. No significant differences were noted regarding ALK or PD-L1 status with AP. Logistic regression models confirmed significant associations between EGFRmt and SO2 (OR 1.36; 95%CI 1.12-1.64; p<0.01), NO2 (OR 1.09, 95%CI 1.01-1.17; p=0.03), PM2.5 (OR: 1.1, 95% CI: 1.01-1.196, p=0.04). Mortality was significantly associated with carbon monoxide (CO) exposure (p<0.01).

Conclusions

Our study is consistent with prior research linking EGFRmt LC with AP. Although our study is limited by retrospective and single-center design, our findings advocate for stringent air quality control measures and provide a foundation for future prospective research.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hospital Universitario Fundacion Santa Fe de Bogota.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.