ASPO Abstracts
Examination of Genetic Alterations in Young Lung Cancer Patients
Category: Early Detection & Risk Prediction
Conference Year: 2019
Abstract Body:
Increased incidence of advanced lung cancer at younger ages has been reported, as well asassociations with certain genetic mutations, such as ALK, EGFR and ROS1, but the resultshave been mixed due to multiple confounding factors, such as smoking status, sex, race,etc. The purpose of this report is to examine associations between genetic mutations andyoung lung cancer, as well as other demographic, clinical and socioeconomic factors. Methods: The Addario Lung Cancer Foundation patient registry provided patient-reporteddemographic and clinical information for 1,181 lung cancer cases. Data were analyzedusing multiple logistic regression models to examine associations between geneticalterations (ALK, ROS1, EGFR, and PDL1) and young lung (age<50), as well as sex, race,education, insurance, marital status, histology, stage at diagnosis, smoking and familycancer history. Results: Of 1,181 cases, the majority (74%) were female, 39% were <age50, 64% were college-educated and 75% were married/partnered, with over half (52%)reporting private insurance, and 51% ever having smoked. Adjusted logistic regressionmodels revealed a 78% increased odds of ALK mutation for those <age 50 (OR=1.78;95%CI=1.18, 2.68), a 2-fold increased odds of ALK for adenocarcinoma vs other histology(OR=1.89; 95% CI=1.11, 3.22) and almost 3-fold increased odds of ALK for late vs earlystage (OR=2.88; 95%CI=1.40, 5.91) and smoking (OR=2.73; 95%CI=1.78, 4.18). The onlysignificant factor associated with EGFR was smoking (OR=2.22; 95%CI=1.38, 4.37), and forROS1 only insurance status approached significance (p=0.06). Late vs early stage was theonly factor associated with PDL1 expression (OR=4.3; 95% CI= 1.3, 12.1). Conclusions:Age remained a significant predictor only for ALK in adjusted models. Insurance (a proxyfor socioeconomic status) only approached significance for ROS1. Smoking was significantfor EGFR and ALK only, which was surprising. PDL1 results by stage indicate increased PDL1expression during tumor progression and aggravation of immunosuppression in themicroenvironment. Overall these results shed new light on predictive factors of geneticalterations. Future research with larger, more diverse populations is needed to furtherrefine and quantify the results.
Keywords: Lung CancerGenetic MutationsALKEGFRPDL1