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Smoking History and Molecular Testing for Lung Adenocarcinoma

By: Joseph Fanelli
Posted: Thursday, January 25, 2018

Smokers and former smokers with adenocarcinoma of the lung and an oncogenic driver mutation seem to benefit as much from targeted therapy as nonsmokers, according to research from the Lung Cancer Mutation Consortium and published in Clinical Cancer Research. Based on these results, the investigators suggest molecular testing be performed on all individuals with lung adenocarcinoma, regardless of smoking history.

“The recommendations have always said you shouldn’t use someone’s smoking history to decide whether that person’s lung cancer should receive broad molecular profiling,” said Dara Aisner, MD, PhD, lead author and investigator at the University of Colorado Cancer Center, in a press release. “This strengthens the science behind those recommendations.”

The consortium enrolled 1,367 patients with lung cancer, 904 of whom were deemed eligible and had at least 1 of 14 cancer-related genes, including EGFR, BRAF, and ROS1. Targeted therapies administered to patients with these mutated genes were associated with a survival increment of 1.5 years compared with those patients who did not receive such therapies. Additionally, 60 patients with a history of smoking derived similar survival benefits from targeted therapy when compared with 75 nonsmokers with the same alterations.

“Essentially, no matter if you do or do not smoke, if your lung cancer holds a targetable alteration, you have the same chance of benefiting from targeted treatments,” Dr. Aisner said.