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Objectives The clinical characteristics and survival of very young (≤40 years) and very old ( > 80 years) patients with advanced non-small cell lung cancer (NSCLC) are distinct. However, the benefits of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) to patients at the extremes of age with NSCLC harboring EGFR mutation have not been well studied. We retrospectively studied the effect of extreme age on patients’ clinical characteristics and prognosis. Materials and methods Of 1510 lung cancer patients diagnosed between November 2010 and March 2014, 555 patients who were tested for EGFR mutations were included. Patients were divided into the following groups according to age: young (≤40 years), lower medium (41–60 years), higher medium (61–80 years), and very old (>80 years). Results Of the 555 patients, 20 (3.6%) patients were aged ≤40 years and 60 (10.8%) patients were aged >80 years. Young NSCLC patients had a lower BMI (p = 0.003), more brain (p = 0.016) and bone metastases (p = 0.002) Very young lung cancer patients still have poor prognosis even they were EGFR mutant. (EGFR mutant vs. wild type patients, OS: 12 vs. 7.3 months, p = 0.215) Very old NSCLC patients had a lower BMI (p = 0.003) and poor ECOG PS (p = 0.028). Positive EGFR mutation test reverses poor prognosis of elderly NSCLC patients. (EGFR mutant vs. wild type patients, OS: 13.2 vs. 4.9 months, p = 0.003) Conclusion We observed EGFR mutations reverse the poor prognosis of old patients with NSCLC. However, young patients with lung cancer have a poor prognosis even if they harbor EGFR mutations. [ABSTRACT FROM AUTHOR]

Objectives In daily practice, some patients with certain clinical characteristics may have better responses to the administration of epidermal growth factor receptor (EGFR)—tyrosine kinase inhibitors (TKIs). It is therefore reasonable to stratify and weigh the importance of these clinical parameters which may not only affect patients’ responses to TKIs but also progression-free survival (PFS) other than the impact of EGFR mutation status per se. Materials and methods This retrospective study evaluated EGFR -mutant, non-small cell lung cancer patients who received EGFR-TKIs as a first-line therapy between January 2011 and December 2013. Several potential prognostic factors were analyzed with respect to PFS, and the results of this analysis were validated in another time cohort. Results A total of 262 patients were included in the study. Age ≤ 40 years, uncommon EGFR mutations, poor performance status, more sites of distal metastasis, and blood lymphocyte to monocyte ratio ≤ 3 were independently associated with poor PFS. These five factors were included in a scoring system and three prognostic groups A, B, and C, were formed based on total scores of 0–1, 2, and ≥3, respectively. In the test group, the PFS was 15.7 month, 9.3 month, and 4.0 month in groups A, B, and C, respectively ( p < 0.001). Between the test and validation groups, no significant differences were found in each one of the three prognostic groups. Conclusions The scoring system appears valid and reproducible for PFS prognosis in EGFR -mutant patients who received first-line EGFR-TKIs. [ABSTRACT FROM AUTHOR]