P2.01-11 Characteristics of Non-Small Cell Lung Cancer: Differences by Sex and Hormonal Status in a Hispanic Population

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Non-small Cell Lung Cancer (NSCLC) appears to be a different disease between women and men. Clinical features and lung cancer behavior by sex and particularly by hormonal status has been poorly approached. We describe the differences in NSCLC by sex and by hormonal status among women in a Hispanic population. We performed a retrospective study among NSCLC patients from the National Cancer Institute of Mexico. We assessed clinic-pathological (tobacco, wood smoke and asbestos exposure, histology, disease stage, ECOG, Body Index Mass, Metastases sites) and molecular characteristics (EGFR and KRAS mutation profile). Overall survival (OS) according to sex and hormonal status were estimated using the Kaplan-Meier method and compared using the Log-rank test. Multivariate cox-proportional analysis was performed adjusting for clinical and statistically relevant features. Among the 1,104 patients 52.7% were men and 47.3% were women. Compared to men, women were more likely to be non-smokers (68% vs. 23%, p<0.001), reported higher frequencies of wood-smoke exposure (50% vs 28.2%, p<0.001), and of EGFR-sensitizing mutations (38.8% vs 18.7%, p<0.001), had a better ECOG performance (<2) (76.2% vs 69.9%, p=0.020) and showed a higher frequency of BMI ³25 (48.4% vs 41.5% p=0.003). Likewise, women, showed better OS (p=0.021) compared to men as well as overweight patients (vs. normal or obese patients) (p=0.045), non-smokers (p=0.002) and patients with lower ECOG status (p=0.006). Differences were found also when considering hormonal status. Postmenopausal women showed higher wood-smoke exposure (52.5% vs 41.7%, p=0.037) and wood-smoke exposure index (113.2% vs 50.6%, p=0.006) as well as tobacco smoking exposure index (19.8 vs 10.2, p=0.017) compared to premenopausal younger women who exhibited higher frequencies of exposure to asbestos (16.7% vs 7.0%, p=0.001) compared to postmenopausal. OS was better in postmenopausal women compared to premenopausal (31.1 vs 19.4 months, p=0.046). No differences were found between premenopausal and postmenopausal women stratified by EGFR mutation status regarding their clinic-pathological and molecular characteristics, neither in the OS. Our results support the differences in lung cancer presentation by sex and also by hormonal status. It is important to highlight that wood-smoke exposure and tobacco consumption were associated with hormonal status. Furthermore, premenopausal women (which showed a younger age at diagnosis) showed a worse OS regardless of other molecular features (e.g. EGFR, KRAS) which highlights the need of investigating in detail hormonal profiles when considering the clinical approach of NSCLC diagnosis and treatment.