Lung cancer remains one of the greatest challenges in modern oncology. In Georgia, a country of approximately 4 million people, it is the leading cause of cancer-related mortality, accounting for nearly 14% of all cancer deaths, with more than 1,500 new cases diagnosed each year. Despite remarkable advances in cancer care, the majority of Georgian patients are still diagnosed with advanced-stage disease, limiting opportunities for curative treatment.<\/p>\n
Over the past two decades, lung cancer treatment has shifted from chemotherapy to precision oncology. Biomarker-guided targeted therapies and immunotherapy have significantly improved patient outcomes. However, access to molecular testing and innovative treatments remains limited in many low- and middle-income countries, including Georgia.<\/p>\n
Population-specific data are essential because the clinicopathological and molecular characteristics of lung cancer vary across populations. As current treatment recommendations are primarily based on international clinical trials, it is important to determine whether Georgian patients share similar disease profiles or exhibit distinct characteristics that may influence treatment decisions. To address this knowledge gap, our research group analyzed the clinicopathological and molecular characteristics of 270 consecutive patients diagnosed at Georgia’s largest tertiary referral center. Our real-world findings provide the first comprehensive overview of lung cancer in the Georgian population, offering valuable insights into disease patterns, opportunities for personalized treatment, and areas requiring further improvement.<\/p>\n
Consistent with global trends, lung cancer in Georgia predominantly affects older adults with a history of tobacco exposure. In our cohort, the median age at diagnosis was 67 years, 86% of patients were male, and 88% of those with available smoking data were current or former smokers. Most patients presented with persistent cough, dyspnea, or fatigue, and nearly two-thirds were diagnosed only after the disease had already metastasized. Early-stage disease remained uncommon, emphasizing the urgent need for greater public awareness, timely referral, and the implementation of national lung cancer screening programs for high-risk individuals.<\/p>\n
Our study demonstrates that also the pathological profile of lung cancer in Georgia mirrors global trends. Non-small cell lung cancer accounts for the vast majority of cases, with adenocarcinoma now representing the most frequent histological subtype. Importantly, adenocarcinoma predominates among never-smokers, illustrating that lung cancer should no longer be regarded solely as a disease of smokers. These findings reinforce the importance of maintaining clinical suspicion even in patients without traditional risk factors.<\/p>\n
One of the most significant advances in lung cancer care is the growing role of molecular diagnostics. Although only a minority of our cohort underwent biomarker testing (64 patients for EGFR, 59 for ALK, and 81 for PD-L1), actionable alterations were identified in a substantial proportion of those tested: 15.6% harbored EGFR mutations, 10% had ALK rearrangements, and 28% had high PD-L1 expression (TPS \u226550%). These findings demonstrate that many Georgian patients are potential candidates for targeted therapies or immunotherapy. Moving beyond the traditional one-size-fits-all chemotherapy approach, biomarker-guided treatment is enabling more personalized care, resulting in longer survival, improved quality of life, and fewer treatment-related toxicities. Realizing the full benefit of these therapeutic advances, however, depends on ensuring that patients have timely access to both comprehensive molecular testing and the corresponding targeted and immune-based treatments.<\/p>\n
Although significant challenges remain, including late-stage diagnosis, limited access to comprehensive molecular testing, and unequal availability of innovative therapies, the landscape of lung cancer care in Georgia is beginning to change. The recent implementation of a national lung cancer screening program represents an important milestone toward earlier detection and improved survival. Combined with expanding access to biomarker testing, multidisciplinary care, and precision oncology, these initiatives offer hope that more patients will benefit from personalized treatment and better long-term outcomes. Continued efforts to broaden access to modern targeted therapies and immunotherapy will be essential to fully translate the promise of precision oncology into routine clinical practice for Georgian patients. Our real-world data provide an important foundation for guiding these efforts and support the continued evolution of lung cancer care in Georgia.<\/p>\n
Author: Anna Geguchadze, MD<\/em><\/strong><\/p>\n Medical Oncologist, Clinical Research Coordinator, Invited Lecturer in Medical Genetics<\/em><\/p>\n Caucasus Medical Centre, European University,<\/p>\n","protected":false},"excerpt":{"rendered":" Lung cancer remains one of the greatest challenges in modern oncology. In Georgia, a country of approximately 4 million people, it is the leading cause of cancer-related mortality, accounting for nearly 14% of all cancer deaths, with more than 1,500 new cases diagnosed each year. Despite remarkable advances in cancer care, the majority of Georgian […]<\/p>\n","protected":false},"author":12,"featured_media":20018,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5963],"tags":[6659],"class_list":["post-23323","post","type-post","status-publish","format-standard","has-post-thumbnail","category-oncofeed-en","tag-anna-geguchadze"],"acf":[],"_links":{"self":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts\/23323","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/comments?post=23323"}],"version-history":[{"count":1,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts\/23323\/revisions"}],"predecessor-version":[{"id":23324,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts\/23323\/revisions\/23324"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/media\/20018"}],"wp:attachment":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/media?parent=23323"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/categories?post=23323"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/tags?post=23323"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}