WCLC 2025 - Posters & ePosters-EP.06.13 Molecular Alterations in Octogenarians With Early-Stage Lung Cancer: A Real-World Study

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This real-world study analyzed molecular alterations in early-stage non-small cell lung cancer (NSCLC) among octogenarians (age ≥80) compared with younger patients, using data from the IELCART prospective multi-institutional cohort. The study included 4601 patients undergoing surgical resection for tumors ≤30 mm, with molecular testing for key actionable genetic mutations such as EGFR, KRAS, MET, ALK, BRAF, RET, ROS1, and HER2.<br /><br />Key findings revealed that octogenarians exhibit a similar overall frequency of actionable mutations as younger patients but have a higher prevalence of EGFR (41% vs. 32%) and MET (11% vs. 5.5%) mutations. KRAS mutations were less common in octogenarians (38%) compared to younger groups (46%). Variations by race aligned with existing literature: EGFR mutations were notably higher in Asians (58%) and KRAS mutations lower (25%) relative to Black and White patients. Smoking status was strongly linked to KRAS mutations, which were most frequent among current and former smokers and least common in never smokers. No significant association was found between actionable mutations and family history of lung cancer.<br /><br />The study highlights the importance of molecular profiling in elderly patients to expand the eligibility for targeted therapies, especially as the population ages and more octogenarians present with early-stage lung cancer. These findings advocate for routine molecular testing regardless of age to inform personalized treatment. Future research will explore additional NSCLC mutations and emerging therapies to further increase targeted treatment options for older patients.<br /><br />Supported by the Simons Foundation, this research fills a gap in understanding the molecular landscape of lung cancer in octogenarians, emphasizing the potential to improve therapeutic strategies in this growing demographic.

Asset Subtitle

Jeffrey Zhu

Meta Tag

Speaker Jeffrey Zhu

Topic Pathology and Biomarkers

Keywords

non-small cell lung cancer

NSCLC

octogenarians

molecular alterations

EGFR mutations

KRAS mutations

MET mutations

targeted therapies

IELCART cohort

early-stage lung cancer