Younger adults with non-small cell lung cancer are significantly more likely than older patients to have tumors with genetic mutations that can be matched to targeted therapies, a large international study found.
Analyzing genomic and immune data from 14,246 patients, researchers found nearly 58% of younger patients had guideline-recommended actionable mutations, compared with about 45% of patients age 55 and older.
The study supports broader use of comprehensive genomic profiling, especially for younger adults diagnosed with non-small cell lung cancer, the most common type of lung cancer. Testing can help doctors identify whether a tumor has a genetic driver that may respond to a targeted therapy.
Younger patients were more likely to have alterations in ALK, ROS1 and EGFR genes - mutations for which there are well-established targeted therapies that can produce dramatic and durable responses.
Older patients’ tumors were more likely to have KRAS-related changes, which have historically been harder to target, and a higher tumor mutational burden, meaning the cancer carried more mutations overall, the study found.
Researchers also found age-related differences in immune markers that are possible targets for future immunotherapy strategies.
The findings point to a gradual shift in tumor biology with age, not a hard divide between younger and older patients, the researchers said.
“By better understanding how tumors change across the lifespan, we can continue refining how we interpret biomarkers, develop new therapies and personalize treatment strategies for patients with lung cancer,” study leader Dr. Chinmay Jani of the University of Miami Miller School of Medicine said in a statement.
Jani expects to report his team’s findings next month in Seoul at the IASLC 2026 World Conference on Lung Cancer.
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