EGFR mutation, smoking, and gender in advanced lung adenocarcinoma.

PURPOSE

In the current targeted therapy era, information on the effect of smoking in epidermal growth factor receptor ()-mutant lung cancer patients is scarce.

RESULTS

In total, 11,678 adenocarcinoma patients were enrolled. Of these, 33.3% and 91.8% of male and female patients were non-smokers, respectively. An increased amount of smoking ( < 0.001 for trend), fewer smoke-free years ( < 0.001 for trend), and younger age of smoking initiation ( = 0.034 for trend) were all associated with significantly lower mutation rates. Smokers had a shorter median overall survival (OS) among both -mutant and -wild type patients (17.8 vs. 21.1 months, and 7.9 vs. 11.4 months respectively; both < 0.001). Among patients with -mutant adenocarcinoma, younger smokers were associated with shorter OS ( = 0.047). In multivariate analysis, female gender was an independent prognostic factor for OS (hazard ratio: 0.86 [95% confidence interval {CI}: 0.80-0.93]; < 0.001 in the -mutant group and 0.88 [95% CI: 0.81-0.96]; = 0.004 in the -wild type group).

MATERIALS AND METHODS

We reviewed the National Lung Cancer database (Taiwan) to assess the impact of smoking on the mutation rate and survival in advanced lung adenocarcinoma patients during 2011 and 2014 retrospectively.

CONCLUSIONS

Smoking was associated with lower incidence of mutation rate and reduced OS of advanced lung adenocarcinoma patients in a dose-dependent manner. In addition to mutation and smoking, gender also plays an important role in survival among these patients.