Tumor Molecular Characteristics Differ between Young and Old Patients

Investigators at Weill Cornell Medicine have identified significant differences in the molecular characteristics of tumors from younger and older cancer patients across several cancer types. Their research, published in Cell Reports, suggests that cancer treatment could potentially be tailored by age. The study also identified pre-existing drugs that could target mutations predominantly found in younger cancer patients—promising candidates for future clinical research.

“The findings demonstrate that we should think about younger and older patients as having different diseases and therefore, treat them differently,” says senior author Olivier Elemento. Typically, studies of age-related differences in molecular characteristics of cancers have been conducted in one tumor type at a time, such as breast cancer, said co-first author Yajas Shah.

For their study, the investigators examined differences in tumor types by age using The Cancer Genome Atlas, a large databank of genomic and gene expression data of primary cancer tumors, and matched healthy tissue samples across 33 cancer types. They identified 16 cancer types with significant differences in overall survival between younger and older patients. Next, they narrowed the list to six with the most marked differences in gene expression between younger and older patients: breast, uterine, ovarian, thyroid, and lung cancers and gliomas, a type of brain cancer. Age ranges for younger and older patients varied by tumor type, with the younger group defined as the youngest 25 percent and the oldest defined as the oldest 25 percent for each cancer type. 

Compared with tumors from older patients, younger patients’ tumors had more mutations associated with aggressive disease and contained more infiltrating immune cells, suggesting that younger patients mount more robust immune responses to more lethal cancers. “Overall, our study shows we should extend the concept of precision medicine to include age,” said Elemento. “We hope it may serve as a blueprint for future clinical studies stratified by age.”