EGFR mutation, smoking, and gender in advanced lung adenocarcinoma.

Purpose: In the current targeted therapy era, information on the effect of smoking in epidermal growth factor receptor ()-mutant lung cancer patients is scarce.

Results: In total, 11,678 adenocarcinoma patients were enrolled. Of these, 33.3% and 91.8% of male and female patients were non-smokers, respectively. An increased amount of smoking ( < 0.001 for trend), fewer smoke-free years ( < 0.001 for trend), and younger age of smoking initiation ( = 0.034 for trend) were all associated with significantly lower mutation rates. Smokers had a shorter median overall survival (OS) among both -mutant and -wild type patients (17.8 vs. 21.1 months, and 7.9 vs. 11.4 months respectively; both < 0.001). Among patients with -mutant adenocarcinoma, younger smokers were associated with shorter OS ( = 0.047). In multivariate analysis, female gender was an independent prognostic factor for OS (hazard ratio: 0.86 [95% confidence interval {CI}: 0.80-0.93]; < 0.001 in the -mutant group and 0.88 [95% CI: 0.81-0.96]; = 0.004 in the -wild type group).

Materials And Methods: We reviewed the National Lung Cancer database (Taiwan) to assess the impact of smoking on the mutation rate and survival in advanced lung adenocarcinoma patients during 2011 and 2014 retrospectively.

Conclusions: Smoking was associated with lower incidence of mutation rate and reduced OS of advanced lung adenocarcinoma patients in a dose-dependent manner. In addition to mutation and smoking, gender also plays an important role in survival among these patients.