Improvement in Survival in Patients With Advanced Non-small Cell Lung Cancer

Area of Science:

• Oncology
• Pulmonology
• Medical Treatment Efficacy

Background:

• Advanced non-small cell lung carcinoma (NSCLC) treatments have improved overall survival (OS) over 20 years.
• Treatment strategies for NSCLC patients with co-existing pulmonary fibrosis remain undefined.

Purpose of the Study:

• To evaluate the impact of underlying pulmonary diseases on OS in stage IV NSCLC patients.
• To assess OS trends and treatment efficacy across different pulmonary conditions in NSCLC.

Main Methods:

• Retrospective review of 581 stage IV NSCLC patients receiving antineoplastic agents.
• Categorization by pulmonary condition (normal, emphysema, fibrosis) and treatment era (2002-2021).
• Comparison of OS with cytotoxic agents (CYs), tyrosine kinase inhibitors (TKIs), and immune checkpoint inhibitors (ICIs).

Main Results:

• OS improved significantly for all NSCLC patients and those with normal lungs or emphysema over two decades.
• Patients with pulmonary fibrosis showed no significant OS improvement (p=0.605).
• TKIs and ICIs improved OS in normal lung and emphysema groups but not in the fibrosis group (p=0.502).

Conclusions:

• Prognosis for advanced NSCLC has improved, excluding patients with pulmonary fibrosis.
• New treatment strategies and therapeutic agents are urgently needed to improve outcomes for NSCLC patients with pulmonary fibrosis.