Multiple Sclerosis and Lung Cancer: A Single Cancer Center Experience in Philadelphia

Area of Science:

• Oncology
• Neurology
• Immunology

Background:

• The link between multiple sclerosis (MS) and lung cancer (LC) is not well understood.
• MS involves immune dysregulation and often requires immunosuppressive therapy, potentially influencing cancer development.
• This study characterizes LC in a cohort of MS patients.

Purpose of the Study:

• To describe the clinical features and outcomes of lung cancer (LC) in patients with multiple sclerosis (MS).
• To investigate the impact of MS and its treatments on LC development and patient prognosis.
• To identify potential therapeutic targets and challenges in managing LC in MS patients.

Main Methods:

• Retrospective analysis of 38 MS patients diagnosed with LC between 2016 and 2023.
• Collected data on patient demographics, MS treatments, LC diagnosis (stage, histology), molecular profiling, and PD-L1 status.
• Analyzed survival data to determine patient outcomes.

Main Results:

• The cohort included 38 patients (27 female, 29 White) with predominantly non-small cell lung cancer (NSCLC).
• Median time between MS and LC diagnosis was 16.3 years; average age at LC diagnosis was 68.2 years.
• 19 patients had stage I LC, and 15 had molecular testing revealing targetable mutations (e.g., EGFR, KRAS) and PD-L1 expression in some cases. Average overall survival was 2.4 years.

Conclusions:

• MS patients with LC often receive immunosuppressive therapies, potentially affecting immune surveillance.
• The study identified targetable mutations and PD-L1 expression in MS patients with LC, but immunotherapy use remains limited.
• Nearly half of the patients presented with early-stage LC, suggesting potentially favorable outcomes, warranting further investigation into the MS-LC relationship.