Clinical and Genetic Characteristics of Early-Onset Lung Adenocarcinoma in a Large Chinese Cohort.

in The Annals of thoracic surgery by Shouzhi Xie, Qikang Hu, Zeyu Wu, Bin Wang, Yu He, Qi Huang, Zhe Zhang, Zhi Yang, Shengrong Wu, Weiyu Yang, Xinhang Hu, Xuyang Yi, Hao He, Cheng Wang, Fenglei Yu, Muyun Peng

TLDR

  • The study looked at the differences between early-onset lung cancer (EOLA) and late-onset lung cancer (LOLA). They found that EOLA patients had different features, such as a higher female-to-male ratio and a higher prevalence of specific gene mutations. This information could help doctors develop more effective treatments for EOLA patients.

Abstract

The characteristics of early-onset lung adenocarcinoma (EOLA) have not been extensively studied. Our research aimed to comprehensively assess the clinical and genetic features of EOLA. We conducted a retrospective analysis of surgically resected lung adenocarcinoma patients, categorizing them into the EOLA group (aged <40 years) and the late-onset lung adenocarcinoma (LOLA) group (aged >60 years). A comparative investigation of clinical, germline, and genomic features was conducted. Propensity score matching was used to balance baseline characteristics for gene mutation analysis. We enrolled 487 EOLA and 2507 LOLA patients. EOLA patients exhibited a higher female-to-male ratio (2.55 vs 1.19) and a higher proportion of family history of lung cancer in the ground-grass opacity subgroup (12.7% vs 8.9%). The EOLA group exhibited higher rates of earlier stage in the ground-grass opacity subgroup and solid subgroup. Preinvasive adenocarcinoma was the dominant histologic subtype in the EOLA group within the ground-glass opacity subgroup (73.8% vs 25.6%). After propensity score matching, we analyzed 241 stage 0/I patients with available genetic test results. Significant disparities in gene mutation rates emerged between the EOLA and LOLA patients, including Erb-B2 receptor tyrosine kinase 2 (ERBB2; 38.0% vs 2.8%), epidermal growth factor receptor (EGFR; 36.0% vs 64.5%), MET (0.0% vs 7.1%), neurofibromin 1 (NF1; 0.0% vs. 5.7%), and anaplastic lymphoma kinase (ALK) fusion (10.0% vs 1.4%). EOLA patients exhibited distinct clinical and genetic characteristics compared with LOLA patients.

Overview

  • The study aimed to comprehensively assess the clinical and genetic features of early-onset lung adenocarcinoma (EOLA).
  • The study used a retrospective analysis of surgically resected lung adenocarcinoma patients, categorizing them into the EOLA group (aged <40 years) and the late-onset lung adenocarcinoma (LOLA) group (aged >60 years).
  • The study compared clinical, germline, and genomic features between the EOLA and LOLA groups.

Comparative Analysis & Findings

  • EOLA patients exhibited a higher female-to-male ratio and a higher proportion of family history of lung cancer in the ground-grass opacity subgroup compared with LOLA patients. The EOLA group exhibited higher rates of earlier stage in the ground-grass opacity subgroup and solid subgroup. Preinvasive adenocarcinoma was the dominant histologic subtype in the EOLA group within the ground-grass opacity subgroup. After propensity score matching, significant disparities in gene mutation rates emerged between the EOLA and LOLA patients, including Erb-B2 receptor tyrosine kinase 2 (ERBB2), epidermal growth factor receptor (EGFR), MET, neurofibromin 1 (NF1), and anaplastic lymphoma kinase (ALK) fusion.

Implications and Future Directions

  • The study highlights the distinct clinical and genetic characteristics of EOLA compared with LOLA. The findings suggest that EOLA patients may have a higher prevalence of specific gene mutations, which could inform targeted therapies and personalized treatment approaches. Future research should continue to explore the genetic and clinical features of EOLA to further understand its underlying biology and develop more effective treatment strategies.
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