Related Experiment Video
Updated: Mar 19, 2026
Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Timeliness of Newer Targeted Therapy and Survival in Lung Cancer: A Population-Based Analysis
Tawee Tanvetyanon1, Utsav Joshi1, Dung-Tsa Chen1
1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
Purpose:
Newer targeted therapy (NTT), addressing alterations in BRAF, MET, NTRK, ROS1, and RET has become a common therapeutic option for non-small cell lung cancer (NSCLC). To date, only RET inhibitor has been shown in a phase III study to confer a survival advantage when used in the frontline setting. This study investigates timing of NTT and its impact on survival using a large, population-base data set.
Methods:
We searched a nationwide, electronic health record-derived, deidentified database for patients with advanced NSCLC treated with NTT between May 2014 and March 2023. Time to treatment initiation (TTI) was calculated from the diagnosis of advanced NSCLC. Landmark analytic technique was used to address immortal time bias.
Results:
Among 857 patients analyzed, the median TTI was 3.8 months. By month 2 or month 3 after diagnosis, patients who already initiated NTT had significantly better survival than those who had not initiated NTT at those time points: Hazard ratio (HR), 0.65 (95% CI, 0.53 to 0.81; P < .001) and HR, 0.69 (95% CI, 0.55 to 0.85; P = .001), respectively. A multivariate analysis indicated that delayed TTI was an independent prognostic factor of decreased survival, along with impaired performance status and squamous cell carcinoma histology. Subgroup analyses excluding RET inhibitor still demonstrated a statistically significant survival advantage in favor of earlier NTT initiation.
Conclusion:
Among advanced NSCLC patients undergoing NTT, survival was significantly better among those who began treatment within 2 or 3 months after diagnosis than those whose treatment was delayed.
Insights
Starting newer targeted therapy (NTT) for advanced non-small cell lung cancer (NSCLC) within 2-3 months of diagnosis significantly improves survival. Delayed treatment initiation is linked to poorer outcomes in NSCLC patients receiving NTT.
Area of Science:
- Oncology
- Medical Informatics
Background:
- Newer targeted therapies (NTT) targeting specific genetic alterations (BRAF, MET, NTRK, ROS1, RET) are increasingly used for non-small cell lung cancer (NSCLC).
- While RET inhibitors have demonstrated a frontline survival advantage in Phase III trials, the optimal timing for initiating NTT across various targets remains under investigation.
Purpose of the Study:
- To investigate the impact of treatment initiation timing on survival outcomes for patients with advanced non-small cell lung cancer (NSCLC) receiving newer targeted therapies (NTT).
- To analyze a large, population-based dataset to understand the relationship between time to treatment initiation (TTI) and overall survival.
Main Methods:
- A deidentified, nationwide electronic health record database was queried for advanced NSCLC patients treated with NTT between May 2014 and March 2023.
- Time to treatment initiation (TTI) was calculated from the date of advanced NSCLC diagnosis.
- Landmark analysis was employed to mitigate immortal time bias.
Main Results:
- The median TTI was 3.8 months among 857 analyzed patients.
- Initiating NTT by 2 or 3 months post-diagnosis was associated with significantly better survival (HR 0.65, P < .001 and HR 0.69, P = .001, respectively).
- Delayed TTI, impaired performance status, and squamous cell carcinoma histology were independent predictors of decreased survival. Earlier NTT initiation showed a survival benefit even when excluding RET inhibitors.
Conclusions:
- For advanced NSCLC patients receiving NTT, initiating treatment within 2 to 3 months of diagnosis is associated with significantly improved survival compared to delayed treatment.
- Timely initiation of NTT is a critical factor in optimizing survival outcomes for NSCLC patients.
More Related Videos
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
05:17Detection of Targetable Alterations in Non-small Cell Lung Cancer using Next-generation Sequencing
Published on: October 10, 2025
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
02:57Targeted Cancer Therapies
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
02:56Treatment Resistent Cancers
02:56Treatment Resistant Cancers
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...