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真实世界中 III 期非小细胞肺癌的治疗模式和结局:中东和非洲 - KINDLE 研究。

Real-world Treatment Patterns and Outcomes in Stage III Non-small Cell Lung Cancer: Middle East and Africa - KINDLE Study.

机构信息

Medical Oncology, Cincinnati Cancer Advisors, Cincinnati, OH, USA.

Radiation Oncology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.

出版信息

Clin Lung Cancer. 2022 Jun;23(4):364-373. doi: 10.1016/j.cllc.2022.02.002. Epub 2022 Feb 11.

Abstract

INTRODUCTION

The Middle East and Africa (MEA)-KINDLE, as part of a real-world global study, evaluated treatment patterns and survival outcomes in stage III non-small cell lung cancer (NSCLC) in the MEA.

MATERIALS AND METHODS

Retrospective data were analyzed from 33 centers for patients diagnosed between January 01, 2013, and December 31, 2017. Descriptive analyses included clinical-demographics and treatment patterns; inferential statistics evaluated an association of first-line treatment with progression-free survival (PFS) and overall survival (OS).

RESULTS

Of 1,046 patients enrolled, the median (range) age was 61.0 years (24.0-89.0); 83.2% were men, 80.8% were current or past smokers, 58.9% had stage IIIA disease, 47.8% had adenocarcinoma and 20.0% of tested (35/175) had epidermal growth factor receptor mutations. Of 86.0% of patients receiving an initial therapy, about 16% underwent surgical resection. Concurrent chemoradiotherapy (cCRT) (32.3%) was the most frequent treatment modality followed by chemotherapy (CT) alone (19.6%) and sequential CRT (12.1%). Median PFS and OS (months, 95% CI) were 11.8 (10.6, 12.4) and 22.9 (21.2, 26.3), respectively for the overall MEA subset. OS (months) was highest with surgery-based therapies for stage IIIA (IIIA: 37.3, IIIB: 24.1) followed by cCRT (IIIA: 28.9, IIIB: 24.4). Female gender, adenocarcinoma, and cCRT or Sx+CRT in first-line were associated with higher OS (P < .05).

CONCLUSIONS

The data reveal an unmet need in stage III NSCLC with worse PFS and OS in the MEA subset than in the global cohort. Better access to newer therapies and quality care will be crucial in improving patient outcomes in the MEA.

摘要

简介

中东和非洲(MEA)-KINDLE 作为一项真实世界的全球研究的一部分,评估了中东和非洲地区 III 期非小细胞肺癌(NSCLC)的治疗模式和生存结果。

材料和方法

对 2013 年 1 月 1 日至 2017 年 12 月 31 日期间在 33 个中心诊断的患者进行回顾性数据分析。描述性分析包括临床人口统计学和治疗模式;推断性统计评估了一线治疗与无进展生存期(PFS)和总生存期(OS)的关联。

结果

在纳入的 1046 名患者中,中位(范围)年龄为 61.0 岁(24.0-89.0);83.2%为男性,80.8%为当前或过去的吸烟者,58.9%为 IIIA 期疾病,47.8%为腺癌,20.0%(35/175)的患者进行了表皮生长因子受体突变检测。在接受初始治疗的 86.0%的患者中,约 16%接受了手术切除。同步放化疗(cCRT)(32.3%)是最常见的治疗方式,其次是单纯化疗(CT)(19.6%)和序贯 CRT(12.1%)。MEA 亚组的中位 PFS 和 OS(月,95%CI)分别为 11.8(10.6,12.4)和 22.9(21.2,26.3)。对于 IIIA 期,基于手术的治疗方法的 OS(月)最高(IIIA:37.3,IIIB:24.1),其次是 cCRT(IIIA:28.9,IIIB:24.4)。女性、腺癌和一线 cCRT 或 Sx+CRT 与更高的 OS 相关(P<.05)。

结论

数据显示,MEA 亚组的 III 期 NSCLC 患者的 PFS 和 OS 均未得到满足,比全球队列更差。在 MEA 地区,更好地获得新疗法和高质量的护理将对改善患者预后至关重要。

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