Instituto Alexander Fleming, Buenos Aires, Argentina.
Universidad Autónoma de Santo Domingo (UASD), Instituto Nacional del Cáncer (INCART), Santo Domingo, Dominican Republic.
Cancer Med. 2023 Jan;12(2):1247-1259. doi: 10.1002/cam4.4990. Epub 2022 Jul 4.
Stage III non-small-cell lung cancer (NSCLC) management is challenging given the heterogeneous nature of the disease. The LATAM subset of the real-world, global KINDLE study reported the treatment patterns and clinical outcomes for LATAM from the pre-immuno-oncology era.
The study was conducted in seven countries (Argentina, Chile, Colombia, Dominican Republic, Mexico, Peru and Uruguay) in stage III NSCLC (American Joint Committee on Cancer, 7th edition) diagnosed between January 2013 and December 2017. Retrospective data from patients' medical records (index date to the end of follow-up) were collected. Summary statistics, Kaplan-Meier survival estimates and a two-sided 95% confidence interval (CI) were provided. Cox proportional hazard model was used for univariate and multi-variate analyses.
A total of 231 patients was enrolled, the median age was 65.0 years (range 21.0-89.0), 60.6% were males, 76.6% had smoking history, 64.0% had adenocarcinoma and 28.7% underwent curative resection. Multiple treatment regimens (>25) were used; chemotherapy alone was the most common (24.8%). The overall median progression-free survival (mPFS) and median overall survival (mOS) were 14.8 months (95% CI, 12.1-18.6) and 48.6 months (95% CI, 34.7 to not calculable). Significantly better mPFS and mOS were observed for stage IIIA with curative surgery and resectable tumours and stage IIIB with an Eastern Cooperative Oncology Group score of 0/1, female gender, resectable tumours, adenocarcinoma and curative surgery (p < 0.05).
Results show diversity in treatment practices and the corresponding clinical outcomes in stage III NSCLC. There is a need to streamline treatment selection and sequencing to decrease relapse rates after initial therapy.
由于疾病的异质性,III 期非小细胞肺癌(NSCLC)的治疗极具挑战性。真实世界全球 KINDLE 研究的拉丁美洲亚组报告了免疫肿瘤学时代前拉丁美洲的治疗模式和临床结果。
该研究在七个国家(阿根廷、智利、哥伦比亚、多米尼加共和国、墨西哥、秘鲁和乌拉圭)进行,纳入了 2013 年 1 月至 2017 年 12 月期间诊断为 III 期 NSCLC(美国癌症联合委员会,第 7 版)的患者。从患者的病历中收集回顾性数据(从索引日期到随访结束)。提供了汇总统计数据、Kaplan-Meier 生存估计值和双侧 95%置信区间(CI)。使用 Cox 比例风险模型进行单变量和多变量分析。
共纳入 231 例患者,中位年龄为 65.0 岁(范围 21.0-89.0),60.6%为男性,76.6%有吸烟史,64.0%为腺癌,28.7%接受了根治性切除术。使用了多种治疗方案(>25 种);单独化疗最常见(24.8%)。总体无进展生存(mPFS)和总生存(mOS)中位数分别为 14.8 个月(95%CI,12.1-18.6)和 48.6 个月(95%CI,34.7 至无法计算)。接受根治性手术和可切除肿瘤的 IIIA 期和 ECOG 评分为 0/1、女性、可切除肿瘤、腺癌和根治性手术的 IIIB 期患者的 mPFS 和 mOS 显著改善(p<0.05)。
结果表明,III 期 NSCLC 的治疗实践和相应的临床结果存在多样性。需要简化治疗选择和序贯治疗,以降低初始治疗后的复发率。