Outcomes in Lung Cancer Affected by Molecular Pathways Linked to Sex and Age

The biology of lung cancer differs from one patient to the next, depending on age and sex, according to scientists at Duke University Medical Center.

The findings may help explain why certain groups of patients do better than others, even though they appear to have the same disease.

"Our study supports two key findings: First, the biology of lung cancer in women is dramatically different from what we see in men. Women, in general, have a less complex disease, at least in terms of the numbers of molecular pathways involved. We also discovered that there is a subset of elderly patients would probably benefit from treatments that we've normally reserved for younger patients," says Anil Potti, M.D., an oncologist in the Duke Institute for Genome Sciences & Policy (IGSP) and the senior author of the study.

Potti says that in the past, physicians have had to rely on very rough measures to categorize patients' lung cancers, factors such as the size of the tumor, the tissue type and the degree to which the cancer had spread. "But this new information tells us that we can analyze patients' disease much more discretely," says Potti. He says the information could also be used to enrich the selection process in clinical trials designed to evaluate new drugs aimed at specific molecular targets.

Physicians have long observed that over time, women with lung cancer tend to do a little better than men, and that younger patients do better than older ones. Potti found that women tend to have only a few cancer-promoting pathways activated in their tumors, where men may have twice as many.