Lung cancer in non-smokers is a different disease from that found in smokers and is likely to require different treatment, a new study published last night has found.
Researchers, co-led by scientists at The Institute of Cancer Research, London, UK, with colleagues from Academia Sinica and the National Taiwan University in Taiwan, hope their findings could lead to new treatments for non-smokers with lung cancer that are tailored to the newly identified genetic changes.
Their study, published in Cell, is the most comprehensive study yet of the biology of lung cancer in non-smokers.
They analysed tumour samples from 103 lung cancer patients in Taiwan, most of whom were non-smokers, and found a range of varying genetic changes that depended on a patient’s age or sex.
The team conducted a detailed analysis of genetic changes, gene activation, protein activity and cellular ‘switches’ in lung cancer and found that some early-stage lung tumours in non-smokers were biologically similar to more advanced disease in smokers.
Tumours in women often had a particular fault in the lung cancer gene EGFR, while in men the most common faults were found in the KRAS and APC genes.
The study found a pattern of genetic changes involving the APOBEC gene family in three quarters of tumours of female patients under the age of 60, and in all women without faults in the EGFR gene.
Groups of patients, particularly older women, whose cancers had mutation patterns linked to cancer-causing substances, such as pollutants, were highlighted, while 65 proteins were identified that were overactive in lung tumours and matched with existing candidate drugs.
Dr Jyoti Choudhary, team leader in functional proteomics at The Institute of Cancer Research, London, said: “Some early-stage lung tumours had molecular features that are much more like that typically seen in later-stage disease – which could help us more accurately diagnose patients with aggressive disease, and inform treatment strategies.”
Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, added: “This new study offers a deep dive into the biology of lung cancer in people who have never smoked. It reveals new ways of telling apart patients with different tumour characteristics that could be exploited with tailored treatment strategies.”
The study was funded by Cancer Research UK and various institutions in Taiwan, including the Ministry of Science and Technology.
Cell 9 July 2020
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