Narjust Florez: First Publication from Dana-Farber’s Young Lung Cancer Program at the Lowe Center for Thoracic Oncology

Narjust Florez, Associate Director of the Cancer Care Equity Program and a Thoracic Medical Oncologist at the Dana-Farber Brigham Cancer Center, shared a post on X by Florez Lab, about a paper she co-authored with colleagues published in Frontiers in Oncology:

“A fantastic team effort and the first publication from our Dana-Farber’s Lowe Center for Thoracic Oncology dedicated Young Lung Cancer Clinical and Research Program.

From diagnosis to survivorship: Young Lung Cancer

We worked on building this program and are honored by the trust of our colleagues across New England (Thank you for your referrals).”

Quoting Florez Lab’s post:

“New Publication.

Young adults do get lung cancer – and they face distinct challenges.

Our latest review, ‘Young lung cancer: from diagnosis to survivorship,’ is now published!

Why focus on young patients with lung cancer?

Because they:

• Are often non-smokers

• Have distinct genomic drivers

• Are more likely to be women or Asian/Pacific Islander

• Face diagnostic delays

• Are underrepresented in screening guidelines

Rising Incidence in Young Adults

While lung cancer rates are overall decreasing, we’re seeing:

• Increases in young Hispanic women in the U.S.

• Young women in Europe

• Stable/increasing trends in parts of Asia

What’s driving this? It’s not smoking.

In fact, many young adults with lung cancer:

• Have no tobacco use history

• May have 2nd-hand smoke exposure

• May be exposed to radon or air pollution

• Could carry rare germline mutations

Still, most screening guidelines exclude them.

Diagnostic Delays are a serious concern.

Why?

• Symptoms often misattributed (e.g. asthma, infections)

• Age bias from providers

• Current screening targets older smokers

Result? Many young adults are diagnosed at advanced stages.

Gender Matters.

Women face:

• Longer time to diagnosis

• Less likelihood of being offered screening

• More consultations before imaging

Gender bias in lung cancer care is real — and costly.

Young lung cancer = high rates of targetable mutations

• 84% <40 w/ adenocarcinoma have 1+

• Common: EGFR, ALK, ROS1, RET, NTRK

• ALK fusions (esp. EML4-ALK) up to 41%

• Uncommon EGFR mut ↑ in young (e.g., exon 20 ins)

• Early biomarker testing is key

Immune landscape in young lung cancer:

• PD-L1+ often oncogene-driven, not immune-driven

• Lower TMB and immune gene expression

• Co-mutations (e.g., TP53, STK11, KEAP1) = ↓ ICI response

Brain metastases are more common in young patients.

So we need:

• CNS-penetrant drugs (e.g. lorlatinib)

• Earlier MRI use

• Better survivorship care

And let’s not forget: many young patients live years post-diagnosis. Survivorship must be planned.

The hidden burdens:

• Fertility concerns

• Financial toxicity

• Psychosocial distress

• End-of-life planning

Young patients face life-altering diagnoses during formative years. We need care models that reflect this.

Bottom Line:

Young adults do get lung cancer.

They are:

• Molecularly distinct

• Clinically unique

• Psychosocially burdened

• Often overlooked

We must improve awareness, screening, diagnostics, and care.

Read our full review.”

Title: Young lung cancer: from diagnosis to survivorship

Authors: Narjust Florez, Lauren Kiel, Rebekah Kaufman, Jaclyn LoPiccolo, Biagio Ricciuti, Angela Morabito, Olayinka Fakorede, Courtney Mantz, Coral Olazagasti, Nishwant Swami, Duaa Kanan, Laura Alder, Arthi Sridhar, Cristiane Decat Bergerot, Bianca Bye, Ana I. Velazquez, Alice T. Shaw.

You can read the Full Article in Frontiers in Oncology.

More posts featuring Narjust Florez and Florez Lab.