Dr. Narjust Florez on the Reality of Lung Cancer in Women

Narjust Florez, MD, FASCO, a thoracic medical oncologist at the Dana-Farber Cancer Institute and Harvard Cancer Center, speaks about unmet needs in women with lung cancer.

Dr. Florez, who specializes in treating young people, especially young women, with lung cancer, delivered a presentation titled “Excluded, Forgotten, and Understudied: The Reality of Lung Cancer in Women” during the 2024 American Society of Clinical Oncology Annual Meeting.

It’s important to recognize that the lung cancer incidence in women increases every year, “particularly in young patients,” who are younger than 50 years old, she said. Since 2018, more young women are being diagnosed with lung cancer than men, but there is a need for greater representation and understanding of lung cancer among women, Dr. Florez explained.

“Unfortunately, gender bias plays a big role here. Women are often ignored [and] excluded when it comes to understanding lung cancer and [participating] in clinical trials,” she said. “When a woman goes to see a doctor and has concerns about lung cancer, it takes almost 3 times as long to be diagnosed with lung cancer compared [with] a man with the same risk factors.”

In addition, there are disparities surrounding lung cancer screening opportunities, Dr. Florez explained.

“When it comes to lung cancer screening, the women [who] qualify for lung cancer screening—particularly women of color—are 6 times less likely to be offered lung cancer screening compared [with] men,” she said.

It’s also important to recognize that “women are often excluded from most lung cancer clinical trials,” she said. This has critical implications for the real-world use of the therapies that are studied in clinical trials and approved upon the basis of their results.

“For immunotherapy trials, 65% of the participants have been men, and people tell me, ‘Oh, that’s back in the day. That doesn’t happen anymore.’ It’s still happening,” she said, noting that even recent studies often have a study population that is two-thirds to three-quarters male.

This lack of representation for women in lung cancer clinical trials is a problem, because “when the drugs get approved, we don’t really understand the drugs in women and women are experiencing more side effects,” Dr. Florez explained, noting that women are 11% less likely to report side effects than men.

“We didn’t test the drugs in women, so we’re learning about the side effects after the drugs are approved,” she said.

There are also important social and family considerations surrounding lung cancer in women, Dr. Florez explained, as women tend to have “3 times more social responsibilities, even when they have very limited time on earth.” In addition, women with lung cancer are less likely be referred to hospice care in a timely manner and are less likely to be visited by hospice nurses, she said.

Dr. Florez concluded by reflecting on her hopes for the future of lung cancer care and treatment for women.

“I will continue to improve awareness and [help ensure] that all women across the globe are heard, are diagnosed on time, are included, and are cared for,” she said.