scholarly journals Treatment patterns and survival outcomes for patients with non-small cell lung cancer in the UK in the preimmunology era: a REAL-Oncology database analysis from the I-O Optimise initiative

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046396
Author(s):  
Michael Snee ◽  
Sue Cheeseman ◽  
Matthew Thompson ◽  
Majid Riaz ◽  
Will Sopwith ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Initial Treatment ◽  
Treatment Patterns ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Over Time

ObjectivesTo report characteristics, treatment and overall survival (OS) trends, by stage and pathology, of patients diagnosed with non-small cell lung cancer (NSCLC) at Leeds Teaching Hospital NHS Trust in 2007–2018.DesignRetrospective cohort study based on electronic medical records.SettingLarge NHS university hospital in Leeds.Participants3739 adult patients diagnosed with incident NSCLC from January 2007 to August 2017, followed up until March 2018.Main outcome measuresPatient characteristics at diagnosis, treatment patterns and OS.Results34.3% of patients with NSCLC were clinically diagnosed (without pathological confirmation). Among patients with known pathology, 45.2% had non-squamous cell carcinoma (NSQ) and 33.3% had squamous cell carcinoma (SQ). The proportion of patients diagnosed at stage I increased (16.4%–27.7% in 2010–2017); those diagnosed at stage IV decreased (57.0%–39.1%). Surgery was the most common initial treatment for patients with pathologically confirmed stage I NSCLC. Use of radiotherapy alone increased over time in patients with clinically diagnosed stage I NSCLC (39.1%–60.3%); chemoradiation increased in patients with stage IIIA NSQ (21.6%–33.3%) and SQ (24.2%–31.9%). Initial treatment with systemic anticancer therapy (SACT) increased in patients with stages IIIB–IV NSQ (49.0%–67.5%); the proportion of untreated patients decreased (30.6%–15.0%). Median OS improved for patients diagnosed with stage I NSQ and SQ and stage IIIA NSQ over time. Median OS for patients with stages IIIB–IV NSQ and SQ remained stable, <10% patients were alive 3 years after diagnosis. Median OS for clinically diagnosed stages IIIB–IV patients was 1.2 months in both periods.ConclusionsOS for stage I and IIIA patients improved over time, likely due to increased use of stereotactic ablative radiation, surgery (stage I) and chemoradiation (stage IIIA). Conversely, OS outcomes remained poor for stage IIIB–IV patients despite increasing use of SACT for NSQ. Many patients with advanced-stage disease remained untreated.

scholarly journals The value of innovation: association between improvements in survival of advanced and metastatic non-small cell lung cancer and targeted and immunotherapy

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sreeram Ramagopalan ◽  
Thomas P. Leahy ◽  
Joshua Ray ◽  
Samantha Wilkinson ◽  
Cormac Sammon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Treatment Patterns ◽  
Small Cell ◽  
Small Cell Lung ◽  
Metastatic Nsclc ◽  
The Past ◽  
Seer Data ◽  
Baseline Characteristics ◽  
Over Time

Abstract Background Significant improvements in mortality among patients with non-small cell lung cancer (NSCLC) in the USA over the past two decades have been reported based on Surveillance, Epidemiology, and End Results (SEER) data. The timing of these improvements led to suggestions that they result from the introduction of new treatments; however, few studies have directly investigated this. The aim of this study was to investigate the extent to which population level improvements in survival of advanced and/or metastatic NSCLC (admNSCLC) patients were associated with changes in treatment patterns. Methods We utilized a de-identified database to select three cohorts of patients with admNSCLC: (1) patients with non-oncogene (EGFR/ALK/ROS1/BRAF) positive tumors, (2) patients with ALK-positive (ALK+) tumors, and (3) patients with EGFR-positive (EGFR+) tumors. All patients were diagnosed with admNSCLC between 2012 and 2019. Multivariable Cox models adjusting for baseline characteristics and receipt of targeted and immunotherapy were utilized to explore the relationship between these variables and changes in the hazard of death by calendar year in each cohort. Results We included 28,154 admNSCLC patients with non-oncogene positive tumors, 598 with ALK+ tumors, and 2464 with EGFR+ tumors eligible for analysis. After adjustment for differences in baseline characteristics, the hazard of death in patients who had non-oncogene positive tumors diagnosed in 2015, 2016, 2017, 2018 ,and 2019 was observed to be 12%, 11%, 17%, 20%, and 21% lower respectively than that for those diagnosed in 2012. Upon additionally adjusting for receipt of first line or second line immunotherapy, the decrease in the hazard of death by calendar year was no longer observed, suggesting improvements in survival observed over time may be explained by the introduction of these treatments. Similarly, decreases in the hazard of death were only observed in patients with ALK+ tumors diagnosed between 2017 and 2019 relative to 2012 but were no longer observed following adjustment for the use of 1st and later generation ALK inhibitors. Among patients with EGFR+ tumors, the hazard of death did not improve significantly over time. Conclusion Our findings expand on the SEER data and provide additional evidence suggesting improvements in survival of patients with advanced and metastatic NSCLC over the past decade could be explained by the change in treatment patterns over this period.

Carbon-ion re-irradiation for recurrences after initial treatment of stage I non-small cell lung cancer with carbon-ion radiotherapy

2017 ◽  
Vol 125 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Masataka Karube ◽  
Naoyoshi Yamamoto ◽  
Hiroshi Tsuji ◽  
Nobuyuki Kanematsu ◽  
Mio Nakajima ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Initial Treatment ◽  
Small Cell ◽  
Stage I ◽  
Carbon Ion Radiotherapy ◽  
Small Cell Lung ◽  
Carbon Ion

scholarly journals Treatment and outcomes for early non-small-cell lung cancer: a retrospective analysis of a Portuguese hospital database

2021 ◽  
pp. LMT46
Author(s):  
Marta Soares ◽  
Luís Antunes ◽  
Patrícia Redondo ◽  
Marina Borges ◽  
Ruben Hermans ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Iiia Nsclc ◽  
One Year

Aim: This observational study evaluated treatment patterns and survival for patients with stage I–IIIA non-small-cell lung cancer (NSCLC). Materials & methods: Adults newly diagnosed with NSCLC in 2012–2016 at IPO-Porto hospital were included. Treatment data were available for patients diagnosed in 2015–2016. Results: 495 patients were included (median age: 67 years). The most common treatments were surgery alone or with another therapy (stage I: 66%) and systemic anticancer therapy plus radiotherapy (stage II: 54%; stage IIIA: 59%). One-year OS (95% CI) for patients with stage I, II and IIIA NSCLC (diagnosed 2012–2016) were 92% (88–96), 71% (62–82) and 69% (63–75), respectively; one-year OS (95% CI) for treated patients with stage I–II or stage IIIA NSCLC (diagnosed 2015–2016) were 89% (81–97) and 86% (75–98) for non-squamous cell and 76% (60–95) and 49% (34–70) for squamous cell NSCLC. Conclusion: Treatment advances are strongly needed for stage I–IIIA NSCLC, especially for patients with squamous cell histology.

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