Lung cancer in adolescent & young adults: Single center experience from Eastern India

Abstract

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, clinicopathological 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. 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.