Lung cancer in non-smokers
Lung cancer in non-smokers accounts for 15–20 % of all lung cancer cases worldwide and is more likely to harbor actionable genomic alterations such as EGFR variants or ALK gene rearrangements, which are associated with improved survival when treated with targeted tyrosine‑kinase inhibitors (TKIs).
Importance: Lung cancer in non‑smokers (defined as people who have smoked fewer than 100 cigarettes in their lifetime) accounts for 15–25 % of all lung cancer cases worldwide. Observations: 60–80 % of lung cancers in non‑smokers are adenocarcinomas, and actionable genomic variants such as EGFR mutations or ALK rearrangements are found in 43 % and 12 % of tumors, respectively, far higher than in smokers (11 % and 2 %). Treatment: Comprehensive next‑generation sequencing is recommended for non‑smoker patients at Stage I–IIIa to identify actionable drivers, which can be targeted with TKIs such as osimertinib (EGFR) or lorlatinib (ALK). Prognosis: Patients with actionable alterations who receive first‑line TKIs can achieve median survival of 3–5 years, compared with 1–2 years for those without such alterations.
This review highlights the distinct biological profile and therapeutic opportunities in lung cancer among non‑smokers, underscoring the importance of genomic testing and tailored targeted therapies to improve survival in this subgroup.
Evidence level: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.
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