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Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Improved overall survival for Stage III NSCLC patients treated with curative-intended therapy from 2010 to 2018-a
Peter Meldgaard1, Michael Kristensen2, Simona Conte3
1Institute for Clinical Medicine, Department of Oncology, Aarhus University Hospital, Denmark.
Background:
Despite advances in treatment strategies and improved clinical outcomes, an unmet need remains for NSCLC patients. With an increased real-world knowledge of NSCLC, clinicians could offer patients optimal tailored treatment and disease management. In this retrospective cohort study, we describe patient characteristics, treatment patterns and modality, and survival in NSCLC patients diagnosed and treated at Aarhus University Hospital, Denmark.
Methods:
Data on Stage III NSCLC patients aged ≥18 years diagnosed 2010-2018 were obtained from a regional cancer database and linked to national registries for information on socioeconomic and vital status. Patients were stratified by planned treatment intention at diagnosis (curative/palliative). Treatment patterns and overall survival (OS) were estimated using time-to-event methods.
Results:
Broad patient and diseases characteristics and multiple treatment options demonstrated the heterogeneity of this patient cohort. Of 851 Stage III NSCLC patients, 599 (70%) and 252 (30%) were offered curative- and palliative-intended treatment, respectively, upon evaluation by a multidisciplinary team (MDT). The most frequent treatment modalities were CRT (n = 328; 55%) and RT (n = 97; 38%) in the curative and palliative setting, respectively. Age, disease stage, performance status and comorbidity were associated with curative-intended treatment initiation. Curative-intended treatment was associated with an improved OS of 14.6 months (median OS 24.4 months, 95% CI 21.1-27.6). Being offered curative-intended treatment and/or being diagnosed in the more contemporary study period (2016-2018) were significantly correlated with better OS (p < 0.001).
Conclusion:
Stage III NSCLC is a heterogeneous disease as regards patient and clinical characteristics, multiple treatment options, and outcomes. Age, disease staging, performance status, and comorbidity, as well as MDT evaluation and matching treatment intent, are important determinants of curative-intended treatment. Notably, an NSCLC diagnosis in the more contemporary study period was statistically significantly associated with better OS.
Insights
This study shows that Stage III non-small cell lung cancer (NSCLC) is diverse. Receiving curative-intended treatment and recent diagnosis significantly improve overall survival for NSCLC patients.
Area of Science:
- Oncology
- Clinical Research
- Public Health
Background:
- Non-small cell lung cancer (NSCLC) treatment advances still leave unmet needs.
- Real-world data can optimize tailored treatment and management for NSCLC patients.
Purpose of the Study:
- To describe patient characteristics, treatment patterns, and survival in Stage III NSCLC patients.
- To analyze factors influencing treatment decisions and outcomes in NSCLC.
Main Methods:
- Retrospective cohort study of Stage III NSCLC patients diagnosed 2010-2018.
- Data linkage with national registries for socioeconomic and vital status.
- Stratification by curative vs. palliative treatment intention and survival analysis.
Main Results:
- 851 Stage III NSCLC patients analyzed; 70% received curative-intended treatment.
- Chemoradiotherapy (CRT) and radiotherapy (RT) were common modalities.
- Curative-intended treatment and contemporary diagnosis (2016-2018) significantly correlated with better overall survival (OS).
Conclusions:
- Stage III NSCLC is heterogeneous regarding patient/clinical factors and outcomes.
- Multidisciplinary team (MDT) evaluation and treatment intent are key determinants for curative treatment.
- Contemporary diagnosis is linked to improved NSCLC survival outcomes.
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