Survival outcomes of young patients with non-small cell lung cancer in Latin America: A real-world cohort study.

Abstract

8067 Background: Young patients with non-small cell lung cancer (NSCLC) represent a distinct biological subgroup, frequently enriched with actionable oncogenic drivers. However, real-world survival data from Latin America are limited. We evaluated survival outcomes and prognostic factors in young versus older patients with NSCLC treated in Peru. Methods: We conducted a retrospective cohort study including patients with histologically confirmed NSCLC treated between 2018and 2024 at a national reference cancer center. Patients were stratified by age at diagnosis (<45 vs ≥45 years). Overallsurvival (OS) was estimated using the Kaplan–Meier method. Multivariable Cox regression was performed adjusting for sex,ECOG performance status, smoking history, clinical stage, histology, molecular alterations and first-line treatment. Results: A total of 317 patients were included; 19.9% were younger than 45 years. The cohort was predominantly female (59.3%),never-smokers (85.5%) and had adenocarcinoma histology (95.6%). Advanced disease (stage III–IV) was present in 94.0% ofcases. Actionable molecular alterations were identified in 69.4% of patients, most commonly EGFR mutations (48.3%).Younger patients showed a higher frequency of actionable mutations compared with older patients (70% vs 56%, p=0.038).After a median follow-up of 40.9 months, 92 deaths (29.0%) were recorded. In adjusted analysis, young age was notassociated with worse OS (adjusted HR 1.32; 95% CI 0.79–2.21; p=0.29). Former smoking history was the only independentpredictor of inferior OS (adjusted HR 2.38; 95% CI 1.16–4.91; p=0.018). Conclusions: Young age at NSCLC diagnosis was not associated with inferior survival. Despite advanced-stage presentation, youngerpatients exhibited a high prevalence of actionable oncogenic drivers, supporting routine comprehensive molecularprofiling. These results provide robust regional evidence and reinforce the importance of precision oncology inunderrepresented populations.