Clinical outcomes of stage-IV non–small-cell lung cancer in young patients and the impact of tumor markers

Q3 Medicine
Pedro Augusto Reck dos Santos , Yalun Li , Vinicius Ernani , Jonathan D'Cunha , Marie-Christine Aubry , Ping Yang
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引用次数: 0

Abstract

Introduction

Non-Small Cell Lung Cancer (NSCLC) diagnosed at a younger age have patterns of care, responses to treatment, and outcomes not entirely clear. A particular feature includes more advanced stages at diagnosis. Our objective was to characterize these young patients with advanced disease and evaluate the impact of targeted therapies.

Methods

Analyzing our cohort of 18,252 newly diagnosed NSCLC patients, we defined Young-age versus Norm-age based on the age distribution at the time of diagnosis. Stage-IV patients were investigated on their clinical information and outcomes; deaths were considered lung cancer-related. Primary outcome was overall survival (OS). Multivariate Cox models were built to evaluate independent prognostic factors in comparative age groups.

Results

We found 4,267 patients with stage-IV NSCLC (359 Young-age; 3,908 Norm-age). Young patients had predominance of females (52.6% vs. 43.3%, P = 0.001), never-smokers (43.2% vs. 14.8%, P < 0.001), and adenocarcinoma (73.5% vs. 62.5%, P < 0.001). Mean OS was 21.1 months in the Young and 15.1 months in Norm, respectively (P < 0.001). Young patients were more often treated with surgery (6.7% vs. 5.0%), chemotherapy (53.2% vs. 44.1%), and targeted therapy (10.6% vs. 5.7%). Molecular studies were assessed in patients when the mutation tests became clinically available (93 Young, 875 Norm) and revealed a critical role of targeted therapy in the improved survival of both age groups.

Discussion

Young patients with stage-IV NSCLC have a specific profile and benefit more when treated with surgery and targeted therapy. Molecular testing is critical in this population, where improved survival was identified. A more aggressive approach to this population needs to be considered.

年轻患者iv期非小细胞肺癌的临床结局及肿瘤标志物的影响
引言癌症(NSCLC)在年轻时被诊断为护理模式、治疗反应和结果并不完全清楚。一个特殊的特征包括诊断的更高级阶段。我们的目的是描述这些患有晚期疾病的年轻患者的特征,并评估靶向治疗的影响。方法分析18252名新诊断的NSCLC患者的队列,根据诊断时的年龄分布,我们定义了年轻年龄与正常年龄。对IV期患者的临床信息和结果进行调查;死亡被认为与肺癌有关。主要结果是总生存率(OS)。建立多变量Cox模型来评估比较年龄组的独立预后因素。结果我们发现4267例IV期NSCLC患者(359名年轻人;3908名正常人)。年轻患者以女性(52.6%对43.3%,P=0.001)、从不吸烟(43.2%对14.8%,P<;0.001)和腺癌(73.5%对62.5%,P>;0.001)为主。年轻患者的平均OS分别为21.1个月和15.1个月(P<;001)。年轻患者更常接受手术(6.7%对5.0%)、化疗(53.2%对44.1%),和靶向治疗(10.6%对5.7%)。当突变测试在临床上可用时,对患者进行了分子研究评估(93 Young,875 Norm),并揭示了靶向治疗在提高两个年龄组生存率方面的关键作用。讨论IV期NSCLC的年轻患者具有特定的特点,在接受手术和靶向治疗时受益更多。分子检测在这一人群中至关重要,在那里发现了存活率的提高。需要考虑对这一群体采取更积极的做法。
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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
148
审稿时长
56 days
期刊介绍: Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.
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