What mutation drivers exist in stage 4 lung cancer at 55?

Question

Hello doctor,

My uncle is 55 years old and was recently diagnosed with stage 4 lung cancer. A biopsy was done, and mutation testing was ordered. His LDH was elevated, and scans showed bone metastases. Treatment has not started yet because the doctor is waiting for reports.

What mutation drivers exist for a 55-year-old stage 4 lung cancer patient?
How common are EGFR or ALK mutations at this age?
If a mutation is found, does it usually change survival or treatment response meaningfully?

The waiting period is stressful, and we want to understand why it matters so much.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Regarding bone metastasis, the management is usually separate. Currently, he can receive radiotherapy to the bone site and also start Denosumab, which is a treatment that reduces bone metastasis and helps with bone preservation, along with calcium and vitamin D.

While we are waiting for the mutation test results, the mutation test is very important, so we can choose the type of targeted therapy and immunotherapy based on it. It is very important to do the mutation test because it makes a difference in management.

Chemotherapy is not always suitable for elderly patients after the age of 55. Chemotherapy can cause unfavorable side effects, so we prefer to know the mutation test result to choose the appropriate targeted therapy afterward. This can lead to tumor shrinkage, downstaging, and a good response.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.