Lung Cancer in Adolescent and Young Adults: Unveiling Challenges and Outcomes—A Report from the Network of Oncology Clinical Trials India
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Adolescent and Young Adult (AYA) cancers (age 18-39) present with unique subset of challenges with regards to their management and outcomes. Network of Oncology Clinical Trials (NOCI) is a collaborative group developed with an academic grant from the Biotechnology Industry Research Assistance Council (BIRAC).This study aimed to determine the clinicopathological features and outcomes of AYA lung cancer patients from the network. Materials and Methods: Data were collected retrospectively from the records from January 1, 2015 to December 31, 2020, after ethics committee approval from each of the six centers in the NOCI network. The data were analyzed for demographic details, baseline characteristics, disease patterns, treatment modalities, and treatment outcomes. Descriptive statistics was used in the form of means/medians for continuous variables and frequencies/percentages for categorical variables. Time to event analysis was done on Kaplan-Meier curves and OS and PFS calculated. Univariate and multivariate analysis was done using log-rank test and cox regression respectively. Results: Total of 51 patients [median age:37 years (23–39), females: 54.9%] were identified. Adenocarcinoma ( n = 34) 66% was the most common histology and 68.6% ( n = 35) were non-smokers. In the majority ( n = 47), 92% of the patients presented with metastatic disease. Exposure to smoking was documented in ( n = 12) 23.5% of subjects. Targeted therapy [EGFR ( n = 5) 42%, ALK ( n = 5) 42%, ROS ( n = 2) 16% was administered in 23.4% of cases. Radiological response of complete response, partial response, and stable disease was observed in 41.3% of patients. The median progression-free survival (PFS) was 8.8 months (95% CI: 5–12.4), and the median overall survival (OS) was 23.8 months(95% CI: 15.6–31.8).The median PFS and OS were superior among those receiving targeted therapy as compared to those receiving chemotherapy (PFS 8 vs. 19 mo, p = 0.72; OS 8 vs. 26 mo, p = 0.15). Conclusions: Unlike what is reported in older individuals, younger lung cancer patients are likely to be non-smokers, and a significant proportion present with targetable mutations. However, the majority have advanced disease and poor survival outcomes. Publication History Article published online: 20 February 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Institutions: Amala Institute of Medical Sciences, All India Institute of Medical Sciences Rishikesh, Meenakshi Mission Hospital and Research Centre, Siksha O Anusandhan University, Institute of Medical Sciences and Sum Hospital, Jawaharlal Institute of Post Graduate Medical Education and Research, Christian Medical College
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7130680828