Lung Cancer in Never Smoker- Precision Medicine and  Strategy Aiming for Cure

09:10-09:40, Room 101 (101講堂)



Pan-Chyr Yang


楊泮池 教授

Chairman, Department of Surgery, Tri-Service General Hospital



Chiun-Sheng Huang


黃俊升 教授

Chairman, Department of Surgery, National Taiwan University Hospital



Kenneth Kenji Tanabe


Chief, Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital

Abstract - 

Lung Cancer in Never Smoker- Precision Medicine and  Strategy Aiming for Cure

Lung cancer is the leading cause of cancer mortality globally. More than 80% of lung cancer is attributable to smoking. Nevertheless, there are still a large number of lung cancer patients who have never smoked. Lung cancer in never smoker is a rising threat worldwide, its incidence is increasing in high social demographic area and especially in East Asia. It is estimated that lung cancer deaths among never-smokers have been ranked the 7th leading cause of cancer mortality. Lung cancer is the No.1 cause of cancer morality both in man and women in Taiwan and 53% of them are never smoker. It is even more striking that 93% of women suffered from lung cancer are never-smoker. We conducted a LDCT screening for lung cancer in never-smokers (TALENT: Taiwan Lung Cancer Screening in never smoker trial) focused on high risk population including family history of lung cancer, environmental exposure, TB/COPD, high cooking index and not using ventilator during cooking. Susceptibility risk SNP genotyping were also analyzed. From Feb. 2015 to Sept. 30, 2020. A total of 12,011 subjects were enrolled, 6,009 have family history of lung cancer. The first round revealed LDCT positive 17.4% (Ground glass opacity >5mm, Solid/Part-solid >6 mm), lung cancer detection rate was 313/12,011 (2.6%) and 96.5% were stage 0-1. The lung cancer first round detection rate was higher than NLST (1.1%) and NELSON (0.9%) that screening focused on heavy smokers. Subjects with first degree family history of lung cancer have higher risk of lung cancer. The identification of EGFR activating mutations in the early of 20th century and the discovery of specific tyrosine kinase inhibitors (TKIs) targeted therapy have opened a new era of precision therapy for lung cancer patients. The implementation of driver gene mutation testing and NGS have significantly improved the treatment outcome of non-small lung cancer (NSCLC) patients. However, most of the patients still eventually developed resistance even to new generation TKIs. The recent evidence of immune check point inhibition for advanced NSCLC supporting that immune oncology may be a promising hope for treatment of lung cancer. However, only 25-30% of advanced NSCLC patients in real-life may benefit from immune check point inhibition. Our recent study in lung cancer proteogenomics helped identify demographically distinct signatures of oncogenesis and progression in never-smokers, our approach has provided new insights on the prevention and precision management of lung cancer in never-smokers.

台大外科林天祐紀念學術論壇暨Massachusetts General Hospital-台大外科聯合會議

The TY Lin Surgical Symposium and
Joint Surgical Conference with MGH & NTUH


2021林天祐紀念學術論壇暨Massachusetts General Hospital-台大外科聯合會議


January 16th, 2021


​臺大醫學院 101 講堂


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