Clinical outcomes of stage-IV non–small-cell lung cancer in young patients and the impact of tumor markers

•Non-small cell lung cancer (NSCLC) diagnosed at a younger age have patterns of care, responses to treatment, and outcomes that not entirely clear. Previous reports highlighted features of this population, including more advanced stages at diagnosis, characterizing a pattern of more aggressive disease.•Analyzing young patients with stage IV NSCLC in current study, we confirmed that they constitute a group with specific characteristics, like predominance of female, never-smokers, and adenocarcinomas.•Our study also found that responses to treatment in this group with stage-IV NSCLC are different: they benefit more when treated with surgery and targeted therapy. Molecular testing seems to play a critical in this population, where improved survival was identified.•Our study reveals a real-world patient cohort with long-term follow-up and comprehensive clinical data that characterized the treatment and prognosis of young patients with metastatic NSCLC. Testing for targeted therapies is critical and a more aggressive approach to this population needs to be considered.