FIRST RESULTS OF A BRAZILIAN NEVER-OR LIGHT-SMOKER NON SMALL CELL LUNG CANCER COHORT: EPIDEMIOLOGY AND MOLECULAR DATA

Introduction: The incidence of lung cancer in non-and light-smokers is increasing worldwide. There are scarce data about their epidemiology, risk factors and molecular landscape in this population of non small cell lung cancer in Brazil. Objective: Here we aimed to present the first results of a Brazilian prospective and uninstitutional cohort of non- or light-smoker NSCLC patients (pts) Methods: From July/2018 to July/2019 we prospectively enrolled all consecutive histologically-proven NSCLC pts (regardless of stage) with a lifetime cigarette/tobacco exposure < 100 cigarettes (defined as never-smokers) or < 10 pack-years per lifetime, and ≥ 15 years since last cigarette (defined as light-smokers). In addition to demographic data, exposure information related to outdoor and indoor air pollution exposure, secondhand smoking, family history of cancer, occupational agents, among others, were obtained by in-person questionnaires. Tumor characteristics such as histopathology and molecular drivers were collected. Symptom burden was evaluated using a validated MD Anderson Symptom Inventory for Lung Cancer scale (0-10) and the MRC dyspnea scale. Written informed consent was obtained from all subjects enrolled in this study. Results: In this first report, 63 pts were studied: 38 female (60%), median age 64 yo (31-82). Only nine (14%) pts were ≤ 45 yo and 36 (57%) were ≥ 60 yo. 55 pts (87%) were never-smokers and 34 pts (54%) were caucasian. Any family history of cancer was present in 38 pts (60%). Household combustion of solid fuel (wood) was mentioned by 27 pts (43%) during their lifetime. Indoor air pollution or tobacco smoke exposure was referred by 43 pts (68%). No illicit abuse drugs was informed. Adenocarcinoma was the most frequent diagnosis (93%), and 59 pts had advanced disease (93%). EGFR activating mutations were detected in 18 pts (29%), ALK translocations in 5 pts (8%), and 1 pt presented ROS1 rearrangement (1.5%). Among those pts with available molecular profiling, 38% had a targetable alteration. Symptoms interfering with general activity, normal work and walking ability were rated with highest degrees. Median MRC dyspnea grade was 1. Conclusion: Non-small cell lung cancer in never- or light-smokers displays distinctive epidemiological and pathological characteristics in this studied population. The high frequency of targetable alterations is a key aspect in treatment selection in these pts.