Molecular genetics and prognosis of lung cancer in young patients: Research highlights SONG Yong, PAN Xian-hui

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1 Med J Chin PLA, Vol. 42, No. 3, March 1, ( ) (CSCO) (IASLC) Translational Lung Cancer Research Journal of Thoracic Disease Military Medical Research 120 SCI81 66 [ ] ( 50 ) (NSCLC) (EGFR) 4- (EML4-ALK) [ ] EML4-ALK [ ] R734.2 [ ] A [ ] (2017) [DOI] /j.issn Molecular genetics and prognosis of lung cancer in young patients: Research highlights SONG Yong, PAN Xian-hui Department of Respiratory and Critical Care Medicine, Nanjing General Hospital of Nanjing Command, Jinling Hospital of Nanjing University, Nanjing, China [Abstract] Differed from the elderly patients with lung cancer, the younger patients with lung cancer, less than 50 years old, present unique clinical features. Recently, the incidence of lung cancer in young people has shown a rising trend, making the research on this field more valuable. At present, molecular targeted therapy is one of the most popular areas of non-small-cell lung cancer (NSCLC), and researches are focused on the epidermal growth factor receptor (EGFR) and echinoderm microtubule associated protein like4-anaplastic lymphoma kinase (EML4-ALK). In addition, the previous researches revealed the differences between the young and elderly patients with lung cancer on molecular genetics and prognosis, so the researches on prognostic factors for young patients with lung cancer are of great clinical significance. The present paper will focus on the aspects of pathogenesis, molecular genetics and prognosis in young patients with lung cancer. [Key words] non-small cell lung cancer; young; age; molecular genetics; echinoderm microtubule associated protein like4- anaplastic lymphoma kinase; epidermal growth factor receptor; treatment; prognosis [1-2] [3] [4] 50 [5-7] 50 [5-6, 8-10] 13.4% [11] [12-13] [ ] ( ) ( )

2 (NSCLC) [14-15] (epidermal growth factor receptor EGFR) [16] 4- (echinoderm microtubule associated protein like4-anaplastic lymphoma kinase EML4-ALK) 1 B [5-6,9,17-18] Thomas [19] NSCLC 30~39 [20] [21] [22-23] Jiang [23] [19,24] 2 EGFR EML4-ALK ROS1 KRAS HER2 BRAF NAS [7] [9,25] % [8] 2.1 EGFR EGFR 7 12~14 18~21 EGFR-TK EGFR MEK/ERK PI3K/AKT EGFR [26-29] NSCLC EGFR 26.0%~38.6% 32.0%~55.0%EGFR Sacher [8] 2237 NSCLC EGFR Hsu [13] NSCLC EGFR 50.0% 51.8% EGFR EGFR [17] [26] 2.2 EML4-ALK ALK ALK 3' EML4 5' EML4 ALK EML4-ALK [30-32] NSCLC ALK 2.0%~7.0% VandenBussche [33] ALK 11.6% ALK36.0% 41.7% [34-35] ALK

3 Med J Chin PLA, Vol. 42, No. 3, March 1, ALK EGFR 11 [35-36] Wang [25] 41 30ALK (GGO) [25,31-32] ALK EML4-ALK [17] [19,37-39] [6,36-38] Arnold [6] 64.0% Igata [10] % % % 42.9% [37] [5-6] EGFR-TKI EGFR EGFR-TKI [13,41-42] ALK NSCLC ALK ( 7 ) ( 10.9 ) [28] 3.2 [8,43] ( 1) Chen [43] EGFR Hsu [13] EGFR-TKI ( ) [42] Sacher [8] 40 ( ~47.3 ) ( ) [44] Chen [43] 555 EGFR EGFR-TKI EGFR-TKI EGFR-TKI EGFR-TKI [45] EGFR EGFR-TKI [43,46] [47] 1 Tab. 1 Survival analysis on young patients with lung cancer Author Publication (year) Sample size (n) PFS after EGFR-TKI treatment (month) OS after EGFR-TKI (month) Hsu CL [13] Maemondo M [43] PFS. Progression free survival; OS. Overall survival Igata [10] ALK518d ALK 130d [10] [48-50] 40 25kg/m 2 EGFR [12,46]

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