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FRESC reanalyzed extensive-stage small-cell lung cancer (ES-SCLC) patient data from the French KBP-2010 cohort to describe the characteristics and therapeutic management of ES-SCLC and provide real-world estimates of survival.A target population of first line (1L) ES-SCLC was identified at initial diagnosis in KBP-2010 (KBP population, N = 796). A KBP-2010 subpopulation was defined as patients who also met the IMpower133 clinicaltrial PS ≤ 1 inclusion criteria (KBP-PS_0/1 population, N = 394). Subgroups were defined according to the 1L ES-SCLC chemotherapy regimens: carboplatin or cisplatin with etoposide (Carb-E or Cisp-E subgroups).The vast majority of KBP populations exhibited stage IV ES-SCLC (84.9%) at initial diagnosis. Median age was 66 years; patients were mostly male and smokers. Patients receiving Cisp + Eto were younger (median age 61 years [55.0-67.0]) and fitter (25.5% had PS ≥ 2) than those receiving Carb + Eto (71 years [62.5-77.5]; 44.1%had PS ≥ 2). Median overall survival (OS) of chemotherapy-treated 1L ES-SCLC patients varied from 7.0 months [95% CI, 6.1; 7.8] in the KBPCarb-Esubgroups to 9.6 months [95% CI, 8.4;10.8] in the KBP Cisp-E subgroup. KBP-PS_0/1 population showed better median OS, especially for the Cisp-E subgroup (10 months [95% CI, 8.7; 11.3]).In the KBP-PS_0/1 population, median OS was close to the one that was found in the IMpower133 control arm. Although this needs to be confirmed by further research, it suggests the transposability of the IMpower133 results to real-life conditions.

Summary Background Topotecan is currently the only drug approved in Europe in a second-line setting for the treatment of small-cell lung cancer. This study investigated whether the doublet of carboplatin plus etoposide was superior to topotecan as a second-line treatment in patients with sensitive relapsed small-cell lung cancer. Methods In this open-label, randomised, phase 3 trial done in 38 hospitals in France, we enrolled patients with histologically or cytologically confirmed advanced stage IV or locally relapsed small-cell lung cancer, who responded to first-line platinum plus etoposide treatment, but who had disease relapse or progression at least 90 days after completion of first-line treatment. Eligible patients were aged 18 years or older and had an Eastern Cooperative Oncology Group performance status 0–2. Enrolled patients were randomly assigned (1:1) to receive combination carboplatin plus etoposide (six cycles of intravenous carboplatin [area under the curve 5 mg/mL per min] on day 1 plus intravenous etoposide [100 mg/m2 from day 1 to day 3]) or oral topotecan (2·3 mg/m2 from day 1 to day 5, for six cycles). Randomisation was done using the minimisation method with biased-coin balancing for ECOG performance status, response to the first-line chemotherapy, and treatment centre. The primary endpoint was progression-free survival, which was centrally reviewed and analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov , NCT02738346 . Findings Between July 18, 2013, and July 2, 2018, we enrolled and randomly assigned 164 patients (82 in each study group). One patient from each group withdrew consent, therefore 162 patients (81 in each group) were included in the intention-to-treat population. With a median follow-up of 22·7 months (IQR 20·0−37·3), median progression-free survival was significantly longer in the combination chemotherapy group than in the topotecan group (4·7 months, 90% CI 3·9–5·5 vs 2·7 months, 2·3–3·2; stratified hazard ratio 0·57, 90% CI 0·41–0·73; p=0·0041). The most frequent grade 3–4 adverse events were neutropenia (18 [22%] of 81 patients in the topotecan group vs 11 [14%] of 81 patients in the combination chemotherapy group), thrombocytopenia (29 [36%] vs 25 [31%]), anaemia (17 [21%] vs 20 [25%]), febrile neutropenia (nine [11%] vs five [6%]), and asthenia (eight [10%] vs seven [9%]). Two treatment-related deaths occurred in the topotecan group (both were febrile neutropenia with sepsis) and no treatment-related deaths occurred in the combination group. Interpretation Our results suggest that carboplatin plus etoposide rechallenge can be considered as a reasonable second-line chemotherapy option for patients with sensitive relapsed small-cell lung cancer. Funding Amgen and the French Lung Cancer Group (Groupe Francais de Pneumo-Cancerologie).

International audience; Objectives The efficacy of osimertinib in pretreated patients with advanced non-small cell lung cancer (NSCLC) harboring EGFR T790 M resistance mutation was demonstrated in clinical trials. However, data on efficacy of osimertinib in real world remain rare. Materials and methods This retrospective multicentric study analyzed T790M-positive advanced NSCLC patients enrolled in French early access program for osimertinib. Patients were pretreated with first- or second-generation EGFR tyrosine-kinase inhibitor and for a majority with chemotherapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS) from osimertinib initiation. Results 205 patients (mean age, 69.5 years; female, 68.8%; adenocarcinoma, 97.5%, never-smokers, 71.5%) were analyzed. Osimertinib was used in second and third line in 18.0% and 82.0% of patients, respectively. Median PFS was 12.4 (95% CI, 10.1-15.1) months. In patients with and without cerebral metastasis, PFS was 9.7 (7.7-13.5) and 15.1 (12.0-17.1) months (p = 0.21), respectively. PFS in second and third line or more was 12.6 (6.7-17.5) and 12.4 (9.7-15.3) months, respectively. Median PFS in patients with EGFR exon 19 deletion and exon 21 mutation was 13.5 (10.1-16.0) and 9.7 (7.4-13.2) months, respectively (p = 0.049). Median OS since osimertinib initiation was 20.5 (16.9-24.3) months: 23.1 (18.6-27.8) and 18.0 (12.2-22.2) months in patients without and with cerebral metastasis (p = 0.11); 17.5 (11.6-27.8) and 21.7 (17.3-24.3) months as second or third line of treatment or more (p = 0.46), respectively. Median OS in patients with EGFR exon 19 deletion and exon 21 mutation was 23.1 (18.6-25.7) and 15.3 (11.6-21.7) months, respectively (p = 0.03). Osimertinib dosage was modified in 8.0% of patients and definitively discontinued for adverse events in 5.9%. Fifty patients benefited from rebiopsy (persistence of T790 M mutation, 44.7%; C797S mutation, 21.1%; cMET amplification, 8.0%). Conclusion In pretreated patients with T790M-mutated advanced NSCLC, the efficacy of osimertinib appears similar in real-world setting to that of clinical trials.

Background: Patients with mild asthma represent a substantial proportion of the population with asthma, yet there are limited data on their true burden of disease. We aimed to describe the clinical and healthcare resource utilisation (HCRU) burden of physician-assessed mild asthma. Methods: Patients with mild asthma were included from the NOVEL observational longiTudinal studY (NOVELTY; NCT02760329), a global, 3-year, real-world prospective study of patients with asthma and/or chronic obstructive pulmonary disease from community practice (specialised and primary care). Diagnosis and severity were based on physician discretion. Clinical burden included physician-reported exacerbations and patient-reported measures. HCRU included inpatient and outpatient visits. Results: Overall, 2004 patients with mild asthma were included; 22.8% experienced >= 1 exacerbation in the previous 12 months, of whom 72.3% experienced >= 1 severe exacerbation. Of 625 exacerbations reported, 48.0% lasted >1 week, 27.7% were preceded by symptomatic worsening lasting >3 days, and 50.1% required oral corticosteroid treatment. Health status was moderately impacted (St George's Respiratory Questionnaire score: 23.5 [standard deviation +/- 17.9]). At baseline, 29.7% of patients had asthma symptoms that were not well controlled or very poorly controlled (Asthma Control Test score = 2 exacerbations in the previous year. In terms of HCRU, at least one unscheduled ambulatory visit for exacerbations was required by 9.5% of patients, including 9.2% requiring >= 1 emergency department visit and 1.1% requiring >= 1 hospital admission. Conclusions: In this global sample representing community practice, a significant proportion of patients with physician-assessed mild asthma had considerable clinical burden and HCRU.

Introduction Le crizotinib et d’autres inhibiteurs de tyrosine kinase ciblant MET ont demontre une efficacite sur des CBNPC exprimant une mutation du gene MET (METexon14) associe a un saut d’exon 14. Il existe de nombreux variants de cette mutation. Certains n’affectent pas les sites d’epissage et donc n’entraineraient pas ce saut d’exon. Pour cette derniere categorie de variants, les tests in silico ne peuvent predire de maniere fiable un saut d’exon. Il pourrait etre important de s’appuyer sur d’autres techniques comme les analyses fonctionnelles. Methodes AFonMET est une etude retrospective multicentrique francaise de vraie vie portant sur l’analyse fonctionnelle des mutations identifiees au voisinage de l’exon 14 et l’efficacite du crizotinib chez des patients porteurs d’un CBNPC de stade IV mute METexon14. Resultats Cent dix neuf patients ont ete inclus entre le 1er decembre 2015 et le 1er juin 2019, dans 13 centres : âge median de 73 ans, 62 % de femmes, non-fumeurs : 47 %, adenocarcinome : 83 %, carcinomes sarcomatoides : 5 %, stade IV : 92 %, metastases cerebrales : 22 %, plus de 3 sites metastatiques : 26 %. Quinze co-amplifications de MET et 22 co-mutations ont ete retrouvees. Les 63 variants differents etaient composes de 69 % de deletions et de 28 % de mutations ponctuelles. 28 % des variants ne touchaient pas les sites d’epissage. 79 (66 %) patients ont beneficie d’au moins un TKI anti MET : crizotinib : 55 (69 %), tepotinib : 18 (22 %), capmatinib : 11 (14 %) et cabozantinib : 2 (3 %). Sept (8,8 %) patients ont beneficie de deux TKI anti MET dans leurs sequences therapeutiques. A la date de point du 1er juin 2020, avec une mediane de suivi de 16 mois, la mediane de survie globale (SG) de la population etait de 22.3 mois (CI95 %, 13.4–28.8). Les medianes de SG des cohortes « traite par crizotinib » et « non-traite par crizotinib » etaient de 21,6 mois (CI95 %, 14.5–29.7) et 27.1 mois (CI95 %, 15.7–42.5) respectivement. Cette difference n’etait pas significative (p= 0.77). Les medianes de SG des cohortes de patients ayant ete expose ou non a un TKI anti MET etaient de 26 mois (CI95 %, 18–28.8) et de 15.3 mois (CI95 %, 5.4-non atteinte) respectivement. Conclusion Dans cette etude de vrai vie, les TKI anti MET augmentent la survie globale des patients porteurs d’un CBNPC de stade IV mute MET exon 14. Les resultats de l’efficacite des anti MET en fonction des analyses fonctionnelles seront presentes au congres.

Background Rash is a common epidermal growth factor receptor inhibitor–induced toxicity that can impair quality of life and treatment compliance. Objective We sought to evaluate the efficacy of doxycycline in preventing erlotinib-induced rash (folliculitis) in patients with non-small-cell lung cancer. Methods This open-label, randomized, prospective, phase II trial was conducted in 147 patients with locally advanced or metastatic non-small-cell lung cancer progressing after first-line chemotherapy, randomized for 4 months with erlotinib alone 150 mg/d per os (control arm) or combined with doxycycline 100 mg/d (doxycycline arm). Incidence and severity of rash, compliance, survival, and safety were assessed. Results Baseline characteristics of the 147 patients were well balanced in the intent-to-treat population. Folliculitis occurred in 71% of patients in the doxycycline arm and 81% in the control arm ( P = .175). The severity of folliculitis and other skin lesions was lower in the doxycycline arm compared with the control arm. Other adverse events were reported at a similar frequency across arms. There was no significant difference in survival between treatment arms. Limitations The open-label design of the study and the duration of the treatment with doxycycline are limitations. Conclusion Doxycycline did not reduce the incidence of erlotinib-induced folliculitis, but significantly reduced its severity.

Background No reference second-line treatment of small-cell lung cancer is available. The aim of the present phase II randomized trial (Groupe Francais de Pneumo-Cancerologie 0501) was to compare, in patients with progressive small-cell lung cancer after first-line platinum-based chemotherapy, oral multidrug chemotherapy (lomustine, cyclophosphamide, etoposide) and intravenous therapy with cyclophosphamide, doxorubicin, and vincristine (CAV) in terms of efficacy and tolerance. The primary endpoint was overall survival. The secondary endpoints were progression-free survival, response rate, and tolerance. Patients and Methods The study randomized 131 patients (76.7% male; median age, 61 ± 8.1 years, 85.5% with a performance status of 0-1), 65 to oral therapy and 66 to the CAV arm. No statistically significant differences were found in the baseline patient characteristics. Results The OS and PFS was 6.1 and 3 months for the oral arm and 5.8 and 3.1 months for the CAV arm, respectively. The control disease rate was 61.6% and 45.5% in oral and CAV arms, respectively. No unexpected adverse events occurred, and no statistically significant difference was found between the 2 arms in terms of toxicity (grade 4 hematologic adverse events in 32.3% and 31.8% of patients in the oral and CAV arms, respectively). Conclusion Compared with CAV, oral therapy in this setting appears as feasible as, but not superior to, the efficacy in the CAV arm.

Introduction ALK-2016-CPHG est une etude observationnelle prospective multicentrique en situation de vie reelle realisee en France dans les centres hospitaliers, visant a inclure 50 a 70 patients adultes traites par crizotinib pour un cancer broncho-pulmonaire presentant le rearrangement ALK (ALK + ) ou ROS1 (ROS1 + ) sur une periode d’inclusion de 23 mois et une periode de suivi de 18 mois. L’objectif principal de cette etude en vie reelle est de decrire les caracteristiques des patients ALK+ ou ROS1+. Les objectifs secondaires sont d’une part l’evaluation de l’efficacite du crizotinib avec le taux de reponse clinique et tumoral, la survie sans progression et la survie globale ; d’autre part la description des modalites de testing, de traitement (adaptation de dose, arret temporaire…), de l’observance, de la tolerance ainsi que de la qualite de vie. Materiel et methodes Soixante-treize patients ont ete inclus dans les 35 centres investigateurs. La presente analyse intermediaire est realisee sur les donnees completees a la visite d’inclusion. Soixante-treize patients ont ete inclus a la date du cut-off (dont deux patients inclus a tort), incluant 50 patients ALK+ et 21 patients ROS1+. Resultats Les patients avaient un âge moyen de 62,1 ans [52 ; 73] avec une predominance de femmes (61,4 %), une majorite de non-fumeurs (55,1 %) et etaient en bon etat general (PS Conclusion Cette analyse preliminaire des donnees a l’inclusion de 73 patients montre une utilisation majoritaire du crizotinib en premiere ligne de traitement conforme a l’AMM, des caracteristiques cliniques et physiologiques comparables aux donnees des essais cliniques de phase III avec un profil de tolerance identique. L’analyse finale sur la population totale donnera une vision precise de la prise en charge en situation de vie reelle dans les centres hospitaliers des patients adultes atteints de CBPNC ALK+ et ROS1+ traites par crizotinib et permettra de comparer les resultats de survie sur une population non selectionnee avec les donnees des essais cliniques.

Introduction La fibroelastose pleuro-parenchymateuse est une recente entite clinicopathologique inclue dans la classification multidisciplinaire internationale des pneumopathies interstitielles idiopathiques de 2012. En 2017, seulement une centaine de cas sont decrits dans la litterature. Methodes Nous rapportons le cas d’un patient de 73 ans presentant une dyspnee stade III NYHA associee a une toux seche. Il a une ACFA paroxystique traitee depuis 1 an par rivaroxaban, amiodarone (entre 2016–2017) bisoprolol, un tabagisme sevre estime a 50 paquets–annees et une exposition professionnelle au sulfate dimethylique, au benzene et au diclorethane. Resultats A l’examen physique, il ne presente pas de platythorax mais un hippocratisme digital et on retrouve des crepitants bibasaux velcros ( Fig. 1 ). La radiographie thoracique retrouve une ascension des hiles et une retraction des sommets. Le scanner thoracique montre des condensations bilaterales a predominance apicales associees a une fibrose sous-pleurale. La fibroscopie bronchique est macroscopiquement normale. Les prelevements microbiologiques sont negatifs (bacteriologie standard, BK et mycologie). Il n’y a pas de cellule neoplasique ni macrophages spumeux. Au LBA, on retrouve une alveolite a 230 mega/L a predominance de PNN. Il a une hypereosinophilie sanguine a 1 G/L et des IgE totales augmentees a 288 Ui/mL. Les serologies VIH, VHB, VHC le bilan d’auto-immunite et la recherche de parsitose domestique sont negatives. Le PET scanner retrouve des fixations moderees des apex (SUV max 3). Au niveau fonctionnel respiratoire, il a trouble ventilatoire restrictif associe a un trouble de diffusion et une hypoxemie de repos, associee a une desaturation au TM6 a 86 % sous 6L/min d’oxygene pour une distance parcourue de 150 metres. La biopsie pulmonaire diagnostique n’est pas conseillee en raison du haut risque de morbi-mortalite et notamment de pneumothorax chronique. Conclusion Ce patient presente une fibroelastose pleuro-parenchymateuse certaine apres avis au centre de competences en maladies rares pulmonaires de Lyon. Son origine professionnelle est fortement suspectee. A l’heure actuelle, aucun traitement n’a demontre d’efficacite en termes de survie ou de ralentissement du declin de la fonction respiratoire. Un traitement par nintedanib est instaure depuis aout 2017.

Background: Chest physicians have a limited experience of primary pulmonary sarcomas, which represent a particular entity among rare intrathoracic neoplasms. Design: Retrospective review of medical records. Purpose: To study patients with primary sarcomas of the lung diagnosed in our pathology department in order to define their clinical characteristics, treatment, and prognosis. Patients: The study group consisted of 12 patients, with a mean age of 53 years. Results: The main symptoms were chest pain, and cough. Imaging findings consisted of: eight single peripheral opacities, three single parahilar opacities, and one lobar actelectasis. The histologic diagnoses confirmed in all cases by detailed immunohistochemical study were leiomyosarcoma (7), monophasic synovial sarcoma (2), one case each of malignant peripheral nerve sheath tumor (MPNST), epithelioid sarcoma, and malignant fibrous histiocytoma. Thoracic surgery done in nine cases consisted of six lobectomies with further parietal resection in two cases, and three pneumonectomies. Four patients received chemotherapy and two patients had radiation therapy postoperatively. Follow up available on 12 patients ranged from 3 to 144 (mean 42) months. Long term survival up to 3 years was observed in five patients. Median overall survival was 48 months. Overall 5-year survival rate was 38%. Conclusions: Primary sarcomas of the lung are a rare and aggressive malignancy. Treatment and prognosis do not differ from other soft tissue sarcomas.

Introduction Les patients âges sont les premiers concernes par les CBNPC et leur prise en charge rarement evaluee specifiquement. L’objectif de cette etude est de decrire en vraie vie en France les strategies therapeutiques de 1 re ligne incluant Bevacizumab chez des patients âges atteints de CBNPC. L’etude vise egalement a decrire leurs caracteristiques, survie sans progression, survie globale et qualite de vie ainsi que la tolerance au traitement. Methodes AVANTAGE est une cohorte prospective multicentrique, conduite chez des patients ≥ 65 ans, debutant une 1 re ligne de chimiotherapie associee a bevacizumab pour le traitement du CBNPC. Les donnees ont ete recueillies a l’inclusion (07/2013 a 12/2015), puis tous les 3 mois pendant 18 mois. Les raisons de non-prise en charge par bevacizumab ont ete recueillies pendant 6 mois. Resultats Deux cent soixante-dix-sept patients traites ont ete inclus dans 72 centres (50 % de CHG, 24 % de cliniques, 21 % de CHU et 5 % de CLCC). Un total de 248 patients ont ete retenus pour l’analyse : hommes (75 %), 65–69 ans (43 %) et ≥ 70 ans (57 %), index ECOG a 0 (42 %), score du questionnaire G8 > 14 (36 %), anciens fumeurs (64 %), stade IV (96 %), index de comorbidite de Charlson ajuste sur l’âge ≤ 3 (43 %). L’association sels de platine-pemetrexed-bevacizumab a ete prescrite chez 186 (75 %) patients (avec cisplatine dans 55 % des cas et carboplatine dans 45 % des cas). Les 62 (25 %) patients n’ayant pas beneficie de cette association ont recu d’autres agents (dont l’association carboplatine-paclitaxel-bevacizumab dans 69 % des cas). La posologie initiale de bevacizumab, instaure des le 1 er ou 2 e cycle de chimiotherapie chez 95 % des patients, etait de 7,5 (70 %) ou 15 (23 %) mg/kg/3 semaines. L’association sel de platine-pemetrexed-bevacizumab a ete prescrite chez 80 % des patients (85/106) de 65–69 ans et chez 71 % des patients (101/142) ≥ 70 ans. Cette association a ete plus frequente chez les patients de 65–69 ans (46 % vs 34 %), avec ECOG a 0 (45 % vs 33 %), score du questionnaire G8 > 14 (38 % vs 29 %), ou index de comorbidite de Charlson ajuste ≤ 3 (45 % vs 36 %). Les principales raisons de non-prescription de bevacizumab (chez les 108 patients repertories) etaient : âge du patient (18 %), localisation centrale de la tumeur (18 %), implication des gros vaisseaux (18 %), maladie arterielle (14 %) et ECOG ≥ 2 (10 %). Conclusion AVANTAGE montre que chez des patients âges eligibles a une chimiotherapie de 1 re ligne avec du bevacizumab, l’association la plus frequemment utilisee est celle d’un sel de platine et du pemetrexed (75 % des cas).

orrigendum to “Randomized open-label non-comparative ulticenter phase II trial of sequential erlotinib and docetaxel versus ocetaxel alone in patients with non-small-cell lung cancer after ailure of first-line chemotherapy: GFPC 10.02 study” Lung Cancer 85 (2014) 415–419] .B. Auliaca,∗, C. Chouaidb, L. Greillierc, I. Monnetd, H. Le Caere, L. Falcherof, R. Correg, . Descourth, S. Bota i, H. Berard j, R. Schottk, A. Bizieuxl, P. Fournelm, A. Labrunien, . Marinn, A. Vergnenegreo, the GFPC team

Aim: The use of a CGA is recommended to detect a patient's vulnerability but its integration in treatment decision making has never been prospectively evaluated. Our main objective was to test if the use of CGA in the allocation of treatment could improve the management of advanced NSCLC in first line. Methods: Randomized, multicentric, prospective phase III study in patients ≥70 y, PS 0-2 with stage IV NSCLC. Arm A standard algorithm of chemotherapy allocation: carboplatin based doublet in PS ≤ 1 and age ≤75y, docetaxel in PS =2 or age >75y. Arm B treatment allocation based on CGA: carboplatin based doublet for fit patients, mono-therapy for vulnerable patients and BSC for frail patients. Four cycles were given every three weeks. Main endpoint: time to failure free survival (TFFS) Secondary endpoints: overall Response Rate (ORR), overall survival (OS), toxicity, QoL and life expectancy adjusted on QoL. QoL was assessed during treatment by EQ-5D health questionnaire at baseline, weeks 6, 12, 20, 28, and 36. A mixed-effects model was used, to compare the utility score and therefore the QOL between arms A and B. Results: 493 patients were randomized from 01/2010 to 01/2013 by 45 centers. Respectively in arms A and B, 34.4% and 47% of patients received a carboplatin-based doublet, 65.6% and 31.4% received docetaxel and in arm B 21.5% received BSC. Median TFFS was 3.2 m, 95%CI:[2.9; 4.1] for standard arm and 3.1 m, 95%CI:[2.7; 4.4] for experimental arm, p = 0.71. Compliance with QoL was 87% at baseline and respectively 66%, 65%, 54%, 60% and 57% at week 6, 12, 20, 28 and 36. The utility score at each evaluation is superior in the experimental arm than in the standard arm, but this difference is significant only at week 36 (p = 0.02). Using a linear mixed generalized model, the utility score tends to decrease over time and is not significantly different between the two arms (p = 0.85). Life expectancy adjusted on QoL was 130.1 days in standard arm and 133.3 days in experimental arm, p = 0.51. Conclusions: ESOGIA did not show a superiority of a CGA-based treatment allocation. In the experimental arm, more patients received a carboplatin-based doublet and 21% of frail patients received an exclusive BSC management. Despite a trend in favor of CGA arm, there is no significant difference in terms of QoL score and life expectancy adjusted on QoL. Further sudies are needed for GA in NSCLC elderly patients. Disclosure: C. Chouaid: advisory board LILLY; H. Lena: advisory board Lilly. All other authors have declared no conflicts of interest.

Aim: Lung cancer in patients under 40 years is infrequent and few data are available about the presentation and outcomes of lung cancer in this population. This study aimed to describe the clinical characteristics, the treatments and the outcome of lung cancer occurring in the population of young adults in France. Methods: A prospective observational clinical study was conducted in 37 centers in France. All patients under 40 years diagnosed with lung cancer between November 2010 and December 2013 were enrolled. Results: One hundred and fifty nine patients with lung cancer were included. Intermediate results are currently available for 117 patients. Median age at diagnosis was 38 (20-40). The proportion of men was 58%. Median time between symptoms and diagnosis was 2 months. The distribution of stages I- II, IIIA and IIIB-IV was 9%, 9% and 82% respectively; 66% were diagnosed with metastasis at presentation and the first metastasis site was brain in 47% of patients. Adenocarcinoma was the most common histologic subtype (78%). EGFR screening was performed for 83 patients and 10% of the patients had an activating mutation. Analysis of other driver biomarkers is ongoing. Eighty-four patients (86%) were current or former tobacco smoker with a median of 20 packs -year. Sixty-nine patients (59%) have been exposed to passive smoking essentially in childhood. About half of them (46%) were current or former cannabis smoker (among which 50% regularly). Socioeconomic status was lower comparing to general population, 24% of the patients had no diploma. The first line treatments were 88% chemotherapy, 43% radiotherapy, 21% surgery and 5% best supportive care. Median overall survival was 14.7 months. Conclusions: This study is the first national prospective study dedicated to patients under 40 years diagnosed with lung cancer. Compared to the general population of lung cancer, our preliminary results show a high proportion of women, adenocarcinoma histology, advanced disease at diagnosis and tobacco and cannabis use. Final analysis will be presented at the congress. Disclosure: All authors have declared no conflicts of interest.

L. Claude, L. Falchero, D. Arpin, D. Perol, M. Vincent, J.F. Cordier, J.C. Guerin, C. Carrie Department of Radiation Oncology, Centre Leon Berard, Lyon, France, Department of Pulmonary Medicine, Centre Hospitalier, Villefranche/Saone, France, Department of Pulmonary Medicine, Hopital des Chanaux, Macon, France, Department of Pulmonary Medicine, Hopital Saint Joseph, Lyon, France, Department of Pulmonary Medicine, Hopital Louis Pradel, Lyon, France, Department of Pulmonary Medicine, Hopital de la Croix-Rousse, Lyon, France