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III期非小细胞肺癌患者的真实世界治疗模式和临床结局:KINDLE-越南队列研究结果

Real-World Treatment Patterns and Clinical Outcomes in Patients With Stage III Non-Small-Cell Lung Cancer: Results of KINDLE-Vietnam Cohort.

作者信息

Van Dao Tu, Diep Tuan Bao, Le Phuong Tri, Huggenberger Reto, Kumar Amit

机构信息

Cancer Research and Clinical Trials Center, Vietnam National Cancer Hospital, Hanoi, Vietnam.

Oncology Department, Hanoi Medical University, Hanoi, Vietnam.

出版信息

Front Oncol. 2022 May 23;12:842296. doi: 10.3389/fonc.2022.842296. eCollection 2022.

Abstract

OBJECTIVE

KINDLE-Vietnam was a part of a real-world KINDLE study with an aim to characterise treatment patterns and clinical outcomes of patients with stage III non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS

Retrospective data from patients diagnosed with stage III NSCLC (American Joint Committee on Cancer, 7 edition) between January 2013 and December 2017 with at least 9 months of follow-up were collected from 2 centres in Vietnam. Descriptive statistics were used to summarise demographics, disease characteristics and treatment modalities. Kaplan-Meier methodology evaluated survival estimates; 2-sided 95% confidence intervals (CIs) were computed. Inferential statistics were used to correlate clinical and treatment variables with median progression-free survival (mPFS) and median overall survival (mOS).

RESULTS

A total of 150 patients (median age: 60 years [range 26-82]) were enrolled; 75.3% were male, 62.0% had smoking history, 56.4% had stage IIIB disease and 62.5% had adenocarcinoma. The majority of the cases (97.3%) were not discussed at a multidisciplinary team meeting. Overall, chemotherapy alone (43.3%), radiotherapy alone (17.0%), sequential chemoradiation (13.5%) and concurrent chemoradiation (12.8%) were preferred as initial therapy. Surgery-based treatment was administered in limited patients (stage IIIA, 10%; stage IIIB, 1.3%). Palliative therapy was the most commonly administered treatment upon relapse in the second-and third-line setting. The mPFS and mOS for the Vietnam cohort were 8.7 months (95% CI, 7.59-9.72) and 25.7 months (95% CI, 19.98-42.61), respectively. The mPFS and mOS for stage IIIA were 11.9 months (95% CI, 8.64-14.95) and 28.2 months (95% CI, 24.15-not-calculable) and for stage IIIB were 7.8 months (95% CI, 6.64-8.71) and 20.0 months (95% CI, 13.01-42.61).

CONCLUSIONS

KINDLE-Vietnam offers insights into the clinical findings of stage III NSCLC. There is a high unmet need for identifying patients in the early stages of NSCLC. Strategies for improving clinical outcomes in this patient population include physician education, multidisciplinary management and catering to increased access to novel agents like immunotherapy and targeted therapy.

摘要

目的

KINDLE - 越南研究是一项真实世界的KINDLE研究的一部分,旨在描述Ⅲ期非小细胞肺癌(NSCLC)患者的治疗模式和临床结局。

材料与方法

收集2013年1月至2017年12月期间在越南2个中心诊断为Ⅲ期NSCLC(美国癌症联合委员会第7版)且至少随访9个月的患者的回顾性数据。采用描述性统计来总结人口统计学、疾病特征和治疗方式。采用Kaplan - Meier方法评估生存估计值;计算双侧95%置信区间(CI)。使用推断性统计将临床和治疗变量与中位无进展生存期(mPFS)和中位总生存期(mOS)进行关联。

结果

共纳入150例患者(中位年龄:60岁[范围26 - 82岁]);75.3%为男性,62.0%有吸烟史,56.4%为ⅢB期疾病,62.5%为腺癌。大多数病例(97.3%)未在多学科团队会议上讨论。总体而言,单独化疗(43.3%)、单独放疗(17.0%)、序贯放化疗(13.5%)和同步放化疗(12.8%)是首选的初始治疗方法。基于手术的治疗仅应用于少数患者(ⅢA期,10%;ⅢB期,1.3%)。姑息治疗是二线和三线治疗复发时最常用的治疗方法。越南队列的mPFS和mOS分别为8.7个月(95%CI,7.59 - 9.72)和25.7个月(95%CI,19.98 - 42.61)。ⅢA期的mPFS和mOS分别为11.9个月(95%CI,8.64 - 14.95)和28.2个月(95%CI,24.15 - 不可计算),ⅢB期的mPFS和mOS分别为7.8个月(95%CI,6.64 - 8.71)和20.0个月(95%CI,13.01 - 42.61)。

结论

KINDLE - 越南研究为Ⅲ期NSCLC的临床发现提供了见解。在NSCLC早期识别患者的需求尚未得到满足。改善该患者群体临床结局的策略包括医生教育、多学科管理以及增加获得免疫治疗和靶向治疗等新型药物的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9169691/14df50ecb84d/fonc-12-842296-g001.jpg

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