Abstract 1383P
Background
More than half of the world’s lung cancer (LC) occur in Asia. Studies reported approximately 0.5-2% of LC are diagnosed before the age of 40. LC in the young is less common with different clinico-molecular characteristics and prognoses. We aim to highlight the clinicopathological features and molecular profile of AYAs with LC in an Asian tertiary institution.
Methods
Patients aged between 16-39 who first presented to the National Cancer Centre Singapore from 2015 to 2019 with LC were included. Demographic features and clinico-pathological characteristics were extracted from our electronic health records. 91 AYA patients were recruited however 12 patients were excluded due to incomplete clinicopathological data. We compared our patients to an older study cohort within our institution from a published database.
Results
Median age of diagnosis was 36 years old (n=79). 11.4%(n=9) were diagnosed under the age of 30. There were more female (58.2%, n=46) and Chinese patients (67.1%, n=53). 35 patients (44.3%) were from other Asian countries. Out of 77 patients with known histological subtypes, most had adenocarcinoma (66.2%, n=51). 72.2%(n=57) had Stage IV disease at presentation. The most common mutations found were the Epidermal growth factor receptor (EGFR) and the anaplastic lymphoma kinase (ALK), both with an incidence of 27.8%(n=22) each. RET proto-oncogene (RET), hepatocyte growth factor oncogene (MET) and Kirsten rat sarcoma oncogene (KRAS) mutation rates were 10.1%(n=8), 10.1%(n=8) and 2.5%(n=2) respectively. 11 patients (13.9%) participated in a clinical trial. 17 patients (21.5%) had brain metastases. Median overall survival was 30 months (1.8 months - 152.0 months).
Conclusions
AYAs with LC have distinct characteristics. Compared to an older cohort, AYAO patients with LC tend to be females (58.2% vs 47%), with a higher ALK mutation rate (27.8% vs 4.0%) and a lower EGFR mutation rate (27.8% vs 53.0). Majority had advanced disease at diagnosis with an aggressive course. We intend to elucidate how their mutational profile and tumour mutation burden can affect their outcomes. Further studies to evaluate reasons for low accrual rate for clinical trials among AYAO patients, the types and responses of clinical trials should be done.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Evelyn Wong Yi Ting.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.