Natual history of non-small cell lung cancer in non-smokers

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Abstract
7252 Background: The natural history of NSCLC differs between never-smokers (NS) and ever-smokers (ES) in terms of incidence, phenotype and genotype. Also, NS with advanced NSCLC demonstrate greater benefit following therapy with EGFR inhibitors than ES. Hence, a greater understanding of the natural history of NS smokers with NSCLC is necessary to interpret the impact of EGFR inhibitor therapy. Methods: A database search for NSCLC from the Utah Cancer registry was performed for 1993–1998. Results: 1796 cases were identified and a smoking history was assessable in 1220 (68%). There were 180 NS, 1040 ES and 576 with unknown smoking history. For NS and ES, the median age was 74 and 68 yrs and the stage breakdown for local, regional and distant was 8.1, 20.9, 70.9% and 9.8, 34.0, 56.1%, respectively. For NS and ES, adenocarcinoma was found in 47.5% and 31% and squamous in 11.5% and 30.1%. For NS and ES, 5-YS for Local was 40.5 and 69.8% and 3-YS for Regional was 34.2 and 22.6%. For NS and ES, the 1, 2 and 3-YS were 23.4, 11.9, 9.3% and 18.6, 6.6, 3.2%. Conclusions: NS with NSCLC present with more advanced stage, greater frequency of adenocarcinoma, but demonstrate greater survival in distant stage than ES suggesting a different natural history for NS with NSCLC. These differences should be considered when interpreting trials of NS or EGFR inhibitors. No significant financial relationships to disclose.

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