Lung Cancer May Develop Differently in Younger Adults
A study of more than 14,000 patients found that younger adults with non-small cell lung cancer are more likely to carry genetic alterations linked to targeted therapies, while older adults show distinct molecular and immune characteristics that may influence treatment decisions.
A large, international study suggests lung cancer is not the same disease across every age group. In younger adults, tumors are more likely to be driven by specific genetic changes doctors can target. In older adults, tumors may carry more accumulated changes that affect how the cancer interacts with the immune system.
Researchers from Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, along with investigators from Labcorp and Dana-Farber Cancer Institute, analyzed genomic and immune data from 14,246 people with non-small cell lung cancer. The study will be presented at the 2026 World Conference on Lung Cancer, Sept. 12-15.
Research Findings
- 1 Younger adults were more likely to have molecular changes that can be matched with existing targeted therapies.
- 2 Nearly 58% of younger patients had guideline-recommended actionable alterations, compared with about 45% of patients age 55 and older.
- 3 Younger patients were more likely to have ALK, ROS1 and EGFR alterations, which can help guide treatment decisions.
- 4 These findings can help physicians better identify which patients may benefit from targeted therapies and support more personalized treatment plans.
Older patients showed a different pattern. Their tumors were more likely to have KRAS-related changes and a higher tumor mutational burden, meaning the cancer carried more mutations overall. Researchers also found age-related differences in immune markers, including LAG3 and TIGIT, which are being studied as possible targets for future immunotherapy strategies.
The findings point to a gradual shift in tumor biology with age, not a hard divide between younger and older patients.
“As precision medicine continues to evolve, we need to think beyond identifying individual mutations and begin understanding the broader biologic context in which those mutations occur,” said Chinmay Jani, M.D., medical oncologist at Sylvester and lead author of the study. “Our findings suggest that age may be an important piece of that puzzle. By better understanding how tumors change across the lifespan, we can continue refining how we interpret biomarkers, develop new therapies and personalize treatment strategies for patients with lung cancer.”
“Age should be considered alongside traditional biomarkers when evaluating treatment options for patients with lung cancer,” said Gilberto Lopes, M.D., Sylvester’s chief and professor of medical oncology, associate director and medical director for international affairs and senior author of the study. “As we learn more about the factors that influence how individual tumors behave, we can make more informed treatment decisions and continue advancing truly personalized cancer care.”
Why This is Important
The study supports broader use of comprehensive genomic profiling, especially for younger adults diagnosed with non-small cell lung cancer. Testing can help doctors identify whether a tumor has a genetic driver that may respond to a targeted therapy.
The researchers also saw consistent, age-related patterns across multiple ancestry groups, strengthening the evidence that age may influence the molecular drivers of lung cancer. Younger adults generally fall outside current lung cancer screening eligibility criteria. Research like this can help identify high-risk populations and inform future efforts to expand or refine screening guidelines to support earlier detection.
The Bottom Line
Age may help explain why lung cancers behave differently from one patient to another. The findings could help researchers refine how doctors interpret biomarkers and choose more individualized treatment strategies. Researchers say the results add to growing evidence that precision medicine should account not only for what mutations are present, but also for how tumor biology changes over a patient’s lifetime.
The research highlights an area where Sylvester, the only NCI-designated cancer center in South Florida, is helping translate scientific discoveries into patient care. The findings underscore the value of comprehensive molecular profiling, which is routinely used at Sylvester to help identify genetic alterations that may guide treatment decisions.
By identifying the specific genetic drivers of a patient’s cancer, physicians can help match patients with targeted therapies, immunotherapies and clinical trials tailored to the biology of their disease. Sylvester’s precision medicine approach enables care teams to use that information to deliver more personalized treatment strategies for patients across the cancer care continuum.
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Tags: Division of Medical Oncology, Dr. Chinmay Jani, Dr. Gilberto Lopes, genomics, lung cancer, Newsroom, non-small cell lung cancer, oncology, precision medicine, Sylvester Comprehensive Cancer Center