Treatment Patterns in Early Stage NSCLC in Asia: Findings From the ELEVATE Study

The management of early stage NSCLC is evolving with new therapies. Given the lack of guidelines for Asia Pacific, understanding the different factors affecting treatment decisions is key to effective clinical practice. This cross-sectional study describes management patterns for early stage NSCLC in six territories across the region and identifies factors influencing treatment choices.

From June 2022 to July 2023, we recruited lung cancer specialists from public and private health care systems in Australia, Hong Kong, South Korea, Singapore, Taiwan, and Vietnam to complete a survey on treatment considerations in early stage NSCLC among three patient groups based on American Joint Committee on Cancer disease staging.

Among 505 physicians screened, 212 were eligible for our study. They frequently screened high-risk individuals. Biomarker testing was common as part of diagnosis and at disease recurrence. Surgery followed by adjuvant chemotherapy, definitive concurrent chemoradiation, and definitive chemoradiation followed by immunotherapy were mostly recommended, depending on disease stage and presence of oncogenic alteration. Variations were observed among territories and specialties. Cisplatin was preferred over carboplatin for both neoadjuvant and adjuvant therapies. Physicians were more likely to prescribe neoadjuvant or adjuvant treatments for patients with lower Eastern Cooperative Oncology Group performance status and/or higher nodal stage.

This study revealed that management of early stage NSCLC across Asia Pacific largely follows international guidelines at the time of survey; however, variations exist. Our findings provide useful insights into real-world management patterns in the region and will be valuable in helping clinicians make informed management decisions.