Family History of Cancer Impacts Survival and Treatment Outcomes in Patients With NSCLC

A recent study highlights the significant impact of family tumor history on disease-free survival in patients with non-small cell lung cancer (NSCLC), suggesting that familial cancer backgrounds could be critical in tailoring treatment strategies. This research appeared in Scientific Reports.

“Lung cancer remains a leading cause of cancer-related mortality worldwide, with NSCLC accounting for approximately 85% of all cases, and it is associated with high morbidity and mortality rates worldwide,” wrote Mengtian Ma, PET/CT Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University and Department of Radiology, Third Xiangya Hospital, Central South University in Changsha, Hunan, China, and coauthors.

Despite advancements in treatment and diagnostics, survival rates have not seen substantial improvements, prompting researchers to explore novel prognostic factors. This study specifically investigates how family history of cancer influences outcomes for patients with patients, focusing on parental and sibling cancer histories and their relationship with tumor glucose metabolism as measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT).

Conducted as a retrospective analysis at The Hunan Cancer Hospital, the study included 414 patients diagnosed with NSCLC between 2013 and 2020. Among these, 24.4% had a family history of cancer. The researchers found that those with a familial history exhibited higher TNM staging and larger tumor sizes, alongside increased glucose metabolism levels in tumors. Notably, colorectal and lung cancer histories were identified as significant risk factors affecting prognosis.

The study also assessed the effectiveness of various treatment modalities. Immunotherapy and targeted therapies significantly improved disease-free survival rates, with hazard ratios of 0.39 and 0.42. However, patients undergoing chemoradiotherapy alone had poorer outcomes if they had a family history of cancer, with a median survival time of 20 months compared to 36 months for those without a family history.

Statistical analyses revealed that family tumor history, along with treatment type and tumor metabolism levels, could enhance prognostic predictions for patients with NSCLC. Family history tumor type showed high predictive performance in the first year (AUC = 0.753), as did treatment method (AUC = 0.700). A multivariate model combining these factors improved predictive accuracy across one (AUC = 0.701), three (AUC = 0.661), and five-year (AUC = 0.683) timelines.

“Our study highlights the importance of considering a patient’s family history when assessing risk profiles and formulating treatment decisions for [patients with] NSCLC,” concluded the study authors.

Reference

Ma M, Tan H, Yan H, Zheng K. The impact of family cancer history on tumor metabolism and prognosis in patients with non-small cell lung cancer. Sci Rep. 2024;14(1):22632. doi:10.1038/s41598-024-73080-w