Clinicopathologic Features of Never-Smoking Women Lung Cancer (WLC): A Review from the Spanish World07 Database

ABSTRACT Background Lung cancer in never-smoker appears to be a distinct entity from lung cancer in smoker, with specific molecular characteristics and potential different treatment. Several factors like hormonal, environmental, genetic, pre-existing lung diseases, and virus, may play etiologic roles, and an in-depth understanding of them is needed. So, new clinicopathologic aspects of never-smoking WLC should be very important to know the biology of this tumoral disease. Methods Information has been extracted from WORLD07 database, a prospective, from 32 Spanish centers, epidemiologic female-specific lung cancer e-database performed by ICAPEM, an association to research WLC. Results From October 2007 to October 2011, 539 newly diagnosed never-smoking WLC were included in World07 database (39.3% of 1371 patients(p). P characteristics are: median age 71.1 years(y) (range: 22-91). Previous history of cancer (%): 13(breast, lung, cervix: 41.4,5.7,2.9). Gynecological features: median age of menarche 13y, Postmenopausal 88.9%, median age of menopause 49y. Median age of first child 26.4y Children: 91.2% (median: 2.3). Oral contraceptive: 11.9%. HRT: 5.2%. Tobacco exposure: Second-hand smokers: 40%, work-exposure 17.1%, home-exposure 88.8%. Obesity: 16.3%. Familiar history of cancer: 39.9% (lung cancer 29.8%).Lung cancer histology (%): adenocarcinoma/BAC/squamous/large cell/SCLC/others: 69.2/6.8/5.7/5.0/3.8/3.8. EGFR mutated p (268 p analized): 55.5%, exon 19/20/21(%): 61.1/7.4/36.9. TNM NSCLC I/II/III/IV (%): 14/3.3/19.8/60.3. Treatment: EGFR-TKI in p harboring EGFR mutations stage IV (1st-/2nd-line)(%): 51.7/15.4; stage IV NSCLC(1st-line)(%): platinum-based chemotherapy 42.5, combinations with bevacizumab 2.9. Overall survival: median 27 months (m), 1/2-y(%) 74.8/55.2; stage IV NSCLC: median 20.5m, 1/2-y(%) 67/46; EGFR mutated p: median 27.3m, 1/2-y(%) 75/54.3. Conclusions Never-smoking WLC represents 39% of Spanish World07 database. The high incidence of adenocarcinoma histology (69.2%) and EGFR mutated tumors suggests a different clinical and genetic profiling and recommend a different treatment approach for this group of patients. Disclosure All authors have declared no conflicts of interest.