scholarly journals Treatment Pattern and Overall Survival of Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicentric Real-World Study in China (CTONG1506)

2020 ◽  
Author(s):  
Qing Zhou ◽  
Yong Song ◽  
Xin Zhang ◽  
Gongyan Chen ◽  
Yiping Zhang ◽  
...  

Abstract Background:CTONG1506, an observational study assessed the real-world treatment patterns and overall survival (OS) of Chinese advanced non-squamous non-small cell lung cancer (NSCLC) patients in current treatment practices.Methods:Patients initiated with 1st line therapy were identified from 12 tertiary hospitals across China. Survival data were collected 1- and 2-years after study initiation. OS was estimated using the Kaplan-Meier method.Results:Among 540 patients with survival data, median OS was 21.4 months (95% CI: 18.1–25.5), and 2-year OS rate was 46.3% (95% CI: 42.0%-51.0%). Median OS for patients with epidermal growth factor receptor (EGFR+) mutation (n = 203), anaplastic lymphoma kinase (ALK+) rearrangement (n = 24), EGFR-/ALK- were 27.9 months (95% CI: 23.4-NA), 24.5 months (95% CI: 18.1-NA), and 15.7 (95% CI: 13.1–21.1) months, respectively. Median OS was not reached in EGFR exon 19 deletion patients compared to EGFR exon 21 L858R mutation patients (21.4 months, 95% CI: 16.7–35.6, P = 0.038). 93 EGFR + patients received tyrosine kinase inhibitor (TKI) alone, 21 received chemotherapy alone and 66 received TKI and chemotherapy [median OS 25.5 months, 18.1 months, and 35.6 months, respectively]. For EGFR + patients, TKI alone was the preferred therapy in 1st (58.2%) and 2nd (56.8%) line when compared to chemotherapy (35.1% and 31.1% respectively). In 3rd line, chemotherapy was preferred (46.0%) over TKI only (38.0%) in these patients.ConclusionsOS for patients with advanced non-squamous NSCLC patients aligned with previous trials. EGFR + patients who received both TKI and chemotherapy had longer median OS, which is consistent with results from other trials.

2018 ◽  
Vol 13 (10) ◽  
pp. S581-S582 ◽  
Author(s):  
L. Schwartzberg ◽  
B. Korytowsky ◽  
J. Penrod ◽  
Y. Yuan ◽  
T. Gu ◽  
...  

Author(s):  
Stefania Nobili ◽  
Daniele Lavacchi ◽  
Gabriele Perrone ◽  
Giulio Vicini ◽  
Renato Tassi ◽  
...  

The use of vinorelbine as a single agent or in combination regimens in non-small cell lung cancer (NSCLC) is associated with satisfactory clinical activity. However, the role of vinorelbine-based chemotherapy in chemonaive locally advanced unresectable or metastatic NSCLC patients, according to real-world treatment patterns, has still not been widely explored. Eighty-one patients treated at a single institution were retrospectively analyzed. Thirty-seven received standard first-line single-agent vinorelbine, and 44 received vinorelbine plus platinum drugs, based on physician’s choice; 61.7% were older than 70 years, and 60.5% were affected by ≥2 comorbidities. Sixty-three patients were evaluable for objective response: 22% achieved partial response and 41% stable disease. Median progression-free survival (PFS) was 5.4 months. A benefit in PFS was observed in patients treated with combinations vs. single-agent vinorelbine (6.7 vs. 3.5 months, p = 0.043). Median overall survival (OS) was 10.4 months without a statistically significant difference between treatments (12.4 vs. 7.5 months). In 55 stage IV patients, OS was positively correlated with combination regimens, M1a stage, or ≤2 metastatic lesions. Grade 3‐4 toxicity occurred in 33% of patients, and dose reduction in 11%. A statistically significant higher incidence of toxicity was observed in patients receiving combinations, in women, in patients younger than 75 years, or patients with metastases. In this real-word analysis, we confirmed the efficacy and tolerability of vinorelbine as a single agent or combined with platinums in patients usually underrepresented in controlled clinical trials. Single-agent vinorelbine may represent a suitable option in elderly or unfit NSCLC patients and warrants investigation as a potential drug candidate for immunochemotherapy combination regimens.


2020 ◽  
Vol 16 (27) ◽  
pp. 2045-2058 ◽  
Author(s):  
Yong-Jin Kim ◽  
Mark Oremus ◽  
Helen H Chen ◽  
Thomas McFarlane ◽  
Devanshi Shah ◽  
...  

Background: The effectiveness of immunotherapies for non-small-cell lung cancer under real-world clinical settings remains uncertain. Materials & methods: Systematic searches of PubMed, EMBASE and Web of Science were conducted. Random-effects models were used to estimate pooled median overall survival and progression-free survival estimates. Results: 36 studies of nivolumab were included for narrative synthesis and 11 of these studies were included for meta-analysis. Age, sex, histology and prior lines of treatment did not affect survival outcomes, while Eastern Cooperative Oncology Group Performance Status and brain metastasis were inversely associated with survival. In the meta-analysis, nivolumab was associated with 9.6 months (95% CI: 8.4–10.9) of overall survival and 2.6 months (95% CI: 1.6–3.6) of progression-free survival. Conclusion: Very-low-certainty evidence suggested the real-world effectiveness of nivolumab was consistent with those observed in the clinical trials.


2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 8547-8547
Author(s):  
Ahmedin Jemal ◽  
Chun Chieh Lin ◽  
Matthew Smeltzer ◽  
Raymond U. Osarogiagbon

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