scholarly journals Comparison of Survival Rates After a Combination of Local Treatment and Systemic Therapy vs Systemic Therapy Alone for Treatment of Stage IV Non–Small Cell Lung Cancer

2019 ◽  
Vol 2 (8) ◽  
pp. e199702 ◽  
Author(s):  
Johannes Uhlig ◽  
Meaghan Dendy Case ◽  
Justin D. Blasberg ◽  
Daniel J. Boffa ◽  
Anne Chiang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Survival Rates ◽  
Local Treatment ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung

Treatment patterns in non-small-cell lung cancer in USA: results of the CancerMPact Survey 2018

2020 ◽  
Vol 16 (7) ◽  
pp. 255-262
Author(s):  
David Robinson ◽  
Stephanie Hawthorne ◽  
Linda Zhao ◽  
Madelyn Hanson ◽  
Gena Kanas ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Combined Therapy ◽  
Stage Iv ◽  
Small Cell ◽  
Treatment Modalities ◽  
Small Cell Lung ◽  
Lung Cancer Patients

Aim: To report the results of a survey of USA physicians (CancerMPact) that treat non-small-cell lung cancer patients. Materials & methods: 60 physicians were surveyed. Questions covered aspects of the treatment for all stages of the disease. Results: For stage I patients, over 70% of the treatments were based on surgery. For stage II/III disease, a strong preference for combined therapy (surgery/radiation/systemic therapy) was observed. For advanced/stage IV patients, physicians used systemic therapy alone, and choosed the regimen based on histology and biomarkers. Use of PD-L1 inhibitors was highly dependent on histology and biomarkers. Conclusion: The treatment choices of non-small-cell lung cancer are increasingly complex, involve different treatment modalities and are highly dependent on histology and biomarkers, besides stage.

scholarly journals Reasons for lack of referral to medical oncology for systemic therapy in stage IV non-small-cell lung cancer: comparison of 2003–2006 with 2010–2011

2017 ◽  
Vol 24 (6) ◽  
pp. 486 ◽  
Author(s):  
J.J. Ko ◽  
R. Tudor ◽  
H. Li ◽  
M. Liu ◽  
K. Skolnik ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Medical Oncology ◽  
Multivariable Analysis ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

IntroductionOnly approximately 25% of stage iv non-small-cell lung cancer (nsclc) patients receive systemic therapy. For such patients, we examined factors affecting referral to a cancer centre (cc) and to medical oncology (mo), and use of systemic therapy.Methods Using the Glans–Look Lung Cancer database, we completed a chart review of stage iv nsclc patients diagnosed in Southern Alberta during 2003–2006 and 2010–2011, comparing median overall survival (mos), referral, and treatment in the two cohorts.Results Of the 922 patients diagnosed in 2003–2006 and the 560 diagnosed in 2010–2011, 94% and 82% respectively were referred to a cc, with 22% and 23% receiving traditional chemotherapy (tctx). Referral to a cc or mo and use of tctx correlated with survival (p < 0.0001): The mos duration was 11.2 months in those receiving tctx and 1.0 months in those not referred to a cc. The overall mos duration was similar in the two cohorts (4.1 months vs. 3.9 months, p = 0.47). Major reasons for lack of referral to mo included poor functional status, rapid decline, and patient wish, which were similar to the reasons for forgoing tctx. In the two cohorts, 87 (9.4%) and 42 (7.5%) patients received epidermal growth factor inhibitors, with a mos duration of 16.2 months. Multivariable analysis showed that male sex [hazard ratio (hr): 1.16; p = 0.008] and pulmonary embolus (hr: 1.2; p = 0.002) correlated with worse survival. In contrast, receipt of chemotherapy (hr: 0.5; p < 0.001) and enrolment in a clinical trial (hr: 0.76; p = 0.049) correlated with better survival.Conclusions Our experience confirms that, over time, uptake of systemic therapy, including tctx and targeted therapy, changed little despite their established efficacy. Most of the factors limiting systemic therapy uptake appear to be non-modifiable at the time of referral. Rapid diagnosis and the availability of well-tolerated drugs for all nsclc patients will likely be the most important factors in increasing systemic therapy uptake in this population.

Phase III Randomized Trial of Docetaxel Plus Cisplatin Versus Vindesine Plus Cisplatin in Patients With Stage IV Non-Small-Cell Lung Cancer: The Japanese Taxotere Lung Cancer Study Group

2004 ◽  
Vol 22 (2) ◽  
pp. 254-261 ◽  
Author(s):  
Kaoru Kubota ◽  
Koshiro Watanabe ◽  
Hideo Kunitoh ◽  
Kazumasa Noda ◽  
Yukito Ichinose ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Combination Chemotherapy ◽  
Survival Rates ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung

Purpose Few randomized trials have demonstrated survival benefit of combination chemotherapy involving new agents plus cisplatin compared with classic combination chemotherapy in advanced non-small-cell lung cancer (NSCLC). The primary aim of this study was to test whether docetaxel plus cisplatin (DC) improves survival compared with vindesine plus cisplatin (VdsC) in patients with previously untreated stage IV NSCLC. Patients and Methods Eligible, stage IV, chemotherapy-naive patients (n = 311) were randomly assigned to receive docetaxel 60 mg/m2 intravenously on day 1 plus cisplatin 80 mg/m2 intravenously on day 1 of a 3- or 4-week cycle, or vindesine 3 mg/m2 intravenously on days 1, 8, and 15 plus cisplatin 80 mg/m2 intravenously on day 1 of a 4-week cycle. Cross-over administration of docetaxel and vindesine was prohibited for both treatment groups. Results Overall, 302 patients were eligible for evaluation. The DC arm demonstrated significant improvements compared with the VdsC arm in overall response rates (37% v 21%, respectively; P < .01) and median survival times (11.3 v 9.6 months, respectively; P = .014). Two-year survival rates were 24% for the DC arm compared with 12% for the VdsC arm. The physical domain of the Quality of Life for Cancer Patients Treated with Anticancer Drugs measure was significantly better in the DC arm than in the VdsC arm (P = .020). Toxicity was predominantly hematologic and was more severe in the VdsC arm. Conclusion As first-line treatment for stage IV NSCLC, DC resulted in greater clinical benefit in terms of response rate (with marked improvements in overall and 2-year survival rates) and quality of life than did treatment with VdsC.

scholarly journals Analyzing the effect of physician assignment in the survival of patients with advanced non-small-cell lung cancer

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
P. Wheatley-Price ◽  
H. Jonker ◽  
K. Al-Baimani ◽  
T. Mhang ◽  
G. Nicholas ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Survival Data ◽  
Advanced Nsclc ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Practice Size

Background Non-small-cell lung cancer (nsclc) is the most common cause of cancer deaths worldwide, with a 5-year survival of 17%. The low survival rate observed in patients with nsclc is primarily attributable to advanced stage of disease at diagnosis, with more than 50% of cases being stage iv at presentation. For patients with advanced disease, palliative systemic therapy can improve overall survival (os); however, a recent review at our institution of more than 500 consecutive cases of advanced nsclc demonstrated that only 55% of the patients received palliative systemic therapy. What is unknown to date is whether that observed low rate of systemic therapy in our previous study is uniform across oncologists.Methods With ethics approval, we performed a retrospective analysis of newly diagnosed patients with stage iv nsclc seen as outpatients at our institution between 2009 and 2012 by 4 different oncologists. Demographics, treatment, and survival data were collected and compared for the 4 oncologists.Results The 4 oncologists saw 528 patients overall, with D seeing 115; L, 158; R, 137; and M, 118. Significant variation was observed in the proportion receiving 1 line or more of chemotherapy: D, 60%; L, 65%; R, 43%; and M, 52%. Physician assignment was not associated with a difference in median os, with D’s cohort having a median os of 6.8 months; L, 8.4 months; R, 7.0 months; and M, 7.0 months.Conclusions Practice size and proportion of patients treated varied between oncologists, but those differences did not translate into significantly different survival outcomes for patients.

Systemic therapy for stage IV non-small cell lung cancer: Single-center U.K. practice 2001-2008.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e18140-e18140
Author(s):  
A. C. Thompson ◽  
C. R. Lewanski ◽  
S. Dubash ◽  
M. Singhera ◽  
S. Mahmoud
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Stage Iv ◽  
Small Cell ◽  
Single Center ◽  
Small Cell Lung

Population-based impacts of new therapies on outcomes for stage IV non-small cell lung cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9120-9120
Author(s):  
Rebekah Rittberg ◽  
Oliver Bucher ◽  
Lin Xue ◽  
Zeb Aurangzeb ◽  
Shantanu Otto Banerji ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Stage Iv ◽  
Population Level ◽  
Population Based ◽  
Small Cell ◽  
Income Quintile ◽  
Small Cell Lung

9120 Background: Over 15 years, diagnostic and therapeutic algorithms for Stage IV non-small cell lung cancer (NSCLC) have dramatically progressed. While clinical trials demonstrate overall survival (OS) advantages, population level impact remains uncertain. Here we evaluate real world, population-based outcomes for Stage IV NSCLC to assess impact of changing therapies on referral, treatment patterns and OS, which may help explain ongoing stigma/nihilism. Methods: A retrospective cohort analysis was completed to evaluate de novo Stage IV NSCLC diagnosed in Manitoba from 2006 to 2015. We evaluated treatment received (not seen by specialist, saw a specialist but did not receive therapy, radiation therapy (RT) only, and systemic therapy (mutation unknown and known)) and treatment era of diagnosis (2006-2009, 2010-2013 and 2014-2015). Multivariable logistic regression assessed systemic therapy predictors. Kaplan-Meier curve and Cox proportional hazard models evaluated OS. Results: 3,601 patients were diagnosed with Stage IV NSCLC, 53% male. Only 21% received systemic therapy, mean age of 62. Within the cohort, 973 (27%) patients did not see a specialist, 610 (17%) saw a specialist but did not receive therapy, 1248 (35%) only received RT, and 771 (21%) received systemic therapy (17% mutation status unknown and 4% known). Younger patients and those with confirmed histology were more likely to see a specialist and receive treatment, each (p < 0.001). Patients who received systemic therapy had lower comorbidity and higher income quintile, each (p < 0.001). Median OS did not differ between treatment era with median OS of 3.0, 2.9 and 2.8 months for 2006-2009, 2010-2013 and 2014-2015 respectively, p = 0.082. When survival analysis was restricted to patients who received systemic therapy, median OS improved by era to 10.9, 11.2 and 15.6 months respectively, p = 0.001. Variables found to be independently associated with survival included treatment type, age, sex and comorbidity. Conclusions: Improved systemic therapy and molecular testing has improved OS for patients who receive systemic therapy. However, due to the large proportion of Stage IV NSCLC patients who never receive systemic therapy we do not see improved survival at a population level between treatment eras.

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