Non-small cell lung cancer in never smokers as a representative ‘non-smoking-associated lung cancer’: epidemiology and clinical features

Yano, Tokujiro; Haro, Akira; Shikada, Yasunori; Maruyama, Riichiroh; Maehara, Yoshihiko

doi:10.1007/s10147-010-0160-8

Cited by 97 publications

(84 citation statements)

References 70 publications

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“…Notably, the majority of never-smoking patients are women and/or patients with adenocarcinoma. The incidence of NSCLC in never-smokers is increased among women and patients with adenocarcinoma compared to the incidence of NSCLC in never-smokers among both surgical (13) and non-resectable advanced-stage patients (17). Both female gender and a diagnosis of adenocarcinoma have been reported to be favorable prognostic factors (22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

“…The multivariate analysis demonstrated that never-smoking is a statistically independent factor for improved survival, in addition to stage and first line treatment. Moreover, it has been suggested that the influence of gender and histology on survival is attributed to smoking status (17).…”

Section: Discussionmentioning

confidence: 99%

“…There is now strong evidence that lung cancer in never-smokers shows different patterns compared to those observed in ever-smokers (15,16). It has been recognized that patients with non-small cell lung cancer (NSCLC) who are lifelong never-smokers constitute a distinct clinical entity (17,18). Only very little is known about the clinical outcomes of never-smoking patients with NSCLC detected with clinicbased screening programs (7).…”

Section: Introductionmentioning

confidence: 99%

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The Impact of a Negative History of Smoking on Survival in Patients with Non-Small Cell Lung Cancer Detected with Clinic-based Screening Programs

et al. 2012

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Objective The aim of this study was to determine the epidemiological characteristics of never-smoking patients with non-small cell lung cancer (NSCLC) detected with clinic-based screening programs, focusing on clinical risk factors and survival. Methods The medical records of NSCLC patients (n=285) diagnosed at Fujisawa City Hospital between April 2000 and December 2010 with lesions that were originally detected with clinic-based screening programs in Fujisawa City were reviewed to identify the clinicopathological variables and survival outcomes. Results Of the 285 NSCLC patients, 95 (33.3%) were never-smokers. A comparison between the neversmoking and ever-smoking patients revealed that the never-smokers included a significantly greater proportion of women and patients with adenocarcinoma (86.3% vs. 12.6%: p<0.001 or 94.7% vs. 55.8%: p<0.001, respectively). The overall survival rate of the never-smoking patients was significantly superior to that of the ever-smokers (p=0.004). In addition to smoking status, factors found to be significantly associated with the overall survival rate in univariate analyses were gender, stage, histology and first line treatment. A multivariate analysis revealed smoking status to be an independent prognostic factor in addition to stage and first line treatment. Conclusion The differences in the clinicopathological factors and survival outcomes between neversmoking and ever-smoking patients with NSCLC detected with clinic-based screening programs suggest that persuading people to never start smoking is important.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of a Negative History of Smoking on Survival in Patients with Non-Small Cell Lung Cancer Detected with Clinic-based Screening Programs

et al. 2012

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“…Smoking status is not, however, the important distinguishing factor in these cases, as EGFR and KRAS mutations commonly occur in both smokers (42,48,77) and nonsmokers and are at the same time mutually exclusive (52). The key distinction is that EGFR mutations, even when identified in current or former smokers, are not caused by smoking (20,87), while two different KRAS mutations -one associated with smoking, the other not associated with smoking -have been identified in the published literature. In a study of KRAS mutations in 482 smokers and and never-smokers, RIELY et al (50) reported that "[n]ever smokers were significantly more likely than former or current smokers to have a transition mutation (G > A) rather than the transversion mutations known to be smoking-related (G > T or G > C; P < 0.0001) ... Based on our data, KRAS mutations are not rare among never smokers with lung adenocarcinoma and such patients have a distinct KRAS mutational profile".…”

Section: Lung Cancer In a Smoker Is Not Inherently Different From Lunmentioning

confidence: 99%

“…YANO et al (87), in a review paper examining lung cancer among never-smokers, made the following observation:…”

Section: They Concluded Thatmentioning

confidence: 99%

Implications of Evolving Medical Science for Proof of Lung Cancer Causation

Frarey¹,

Martínez²

2015

Beiträge Zur Tabakforschung International/Contributions to Tobacco Research

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SummaryCausal determination in cases of diseases involving multiple risk factors and long development time poses formidable challenges to judges and juries. Numerous scientific, medical and legal questions are involved. For example, is the mere presence of a factor known to be associated with elevated disease risk sufficient for a causal determination? If not, what level of exposure should be deemed sufficient, and how can that exposure be measured with adequate confidence over an extended period? In the presence of two or more factors associated with elevated disease risk, how can causation be demonstrated and apportioned among these factors, particularly when the potential effects of their interaction are unknown? With increasing knowledge of the molecular and genetic changes involved in disease development, what level of comprehension and proof is sufficient to implicate a specific risk factor in the complex causal mechanism of an individual’s disease? Lung cancer, notwithstanding its strong association with cigarette smoking, represents a group of diseases associated with both a variety of risk factors and relatively long development time. Both the published scientific literature and current clinical practice for the treatment of lung cancer, particularly lung adenocarcinoma, reflect the rapid changes that have occurred in this field over the past decade. These medical advances, in addition to promising better prognosis for some lung cancer patients, have implications for the proof of lung cancer causation in litigation in which plaintiffs contend that tobacco smoke exposure caused their disease. This is particularly true in cases arising in many European countries and other jurisdictions in which little or no histological or cytological information has been produced by plaintiffs. This paper examines the rapidly evolving science underpinning lung cancer diagnosis and treatment and its forensic implications. [Beitr. Tabakforsch. Int. 26 (2015) 298-311]

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Fibroblast growth factor signaling and inhibition in non‐small cell lung cancer and their role in squamous cell tumors

Salgia

2014

Cancer Medicine

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With the introduction of targeted agents primarily applicable to non-small cell lung cancer (NSCLC) of adenocarcinoma histology, there is a heightened unmet need in the squamous cell carcinoma population. Targeting the angiogenic fibroblast growth factor (FGF)/FGF receptor (FGFR) signaling pathway is among the strategies being explored in squamous NSCLC; these efforts are supported by growth-promoting effects of FGF signaling in preclinical studies (including interactions with other pathways) and observations suggesting that FGF/FGFR-related aberrations may be more common in squamous versus adenocarcinoma and other histologies. A number of different anti-FGF/FGFR approaches have shown promise in preclinical studies. Clinical trials of two multitargeted tyrosine kinase inhibitors are restricting enrollment to patients with squamous NSCLC: a phase I/II trial of nintedanib added to first-line gemcitabine/cisplatin and a phase II trial of ponatinib for previously treated advanced disease, with the latter requiring not only squamous disease but also a confirmed FGFR kinase amplification or mutation. There are several ongoing clinical trials of multitargeted agents in general NSCLC populations, including but not limited to patients with squamous disease. Other FGF/FGFR-targeted agents are in earlier clinical development. While results are awaited from these clinical investigations in squamous NSCLC and other disease settings, additional research is needed to elucidate the role of FGF/FGFR signaling in the biology of NSCLC of different histologies.

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Non-small cell lung cancer in never smokers as a representative ‘non-smoking-associated lung cancer’: epidemiology and clinical features

Cited by 97 publications

References 70 publications

The Impact of a Negative History of Smoking on Survival in Patients with Non-Small Cell Lung Cancer Detected with Clinic-based Screening Programs

The Impact of a Negative History of Smoking on Survival in Patients with Non-Small Cell Lung Cancer Detected with Clinic-based Screening Programs

Implications of Evolving Medical Science for Proof of Lung Cancer Causation

Fibroblast growth factor signaling and inhibition in non‐small cell lung cancer and their role in squamous cell tumors

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