Danesi Valentina, Massa Ilaria, Foca Flavia, Delmonte Angelo, Crinò Lucio, Bronte Giuseppe, Ragonesi Maria, Maltoni Roberta, Manunta Silvia, Cravero Paola, Andrikou Kalliopi, Priano Ilaria, Balzi William, Gentili Nicola, Burke Thomas, Altini Mattia
Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.
Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.
Cancers (Basel). 2022 Sep 15;14(18):4481. doi: 10.3390/cancers14184481.
This study provides insights into the treatment use and outcomes of metastatic non-small cell lung cancer (NSCLC) patients in a real-world setting prior to and after the availability of immuno-oncology (IO) regimens in the first line (1L).
Metastatic NSCLC patients, who initiated systemic 1L anticancer treatment from 2014 to 2020, were identified from health records. Patients were grouped into Pre-1L IO and Post-1L IO, according to the availability of pembrolizumab 1L monotherapy at the date of initiating 1L systemic anticancer treatment. Patient characteristics, treatment patterns and outcomes were assessed by the cohort. Overall survival (OS) and real-world progression-free survival (rwPFS) were calculated using the Kaplan-Meier method.
The most common 1L treatment was platinum-based chemotherapy regimens in both groups (≥46%), followed by single-agent chemotherapy (27.0%) in Pre-1L IO and pembrolizumab (26.0%) in Post-1L IO. Median OS was 6.2 (95% CI 5.5-7.4) in Pre- and 8.9 months (95% CI 7.5-10.6) in Post-1L IO, while rwPFS was 3.7 (95% CI 3.3-4.2) and 4.7 months (95% CI 3.9-5.7), respectively.
Even if a small proportion of patients received a 1L IO, the data showed an improved survival outcomes in the Post-1L IO group.
本研究深入探讨了一线（1L）免疫肿瘤（IO）方案出现之前和之后，转移性非小细胞肺癌（NSCLC）患者在真实世界中的治疗使用情况及治疗结果。
从健康记录中识别出2014年至2020年开始接受一线全身抗癌治疗的转移性NSCLC患者。根据开始一线全身抗癌治疗之日帕博利珠单抗一线单药治疗的可用性，将患者分为一线免疫治疗前组（Pre-1L IO）和一线免疫治疗后组（Post-1L IO）。通过队列评估患者特征、治疗模式和治疗结果。采用Kaplan-Meier方法计算总生存期（OS）和真实世界无进展生存期（rwPFS）。
两组中最常见的一线治疗均为铂类化疗方案（≥46%），其次是一线免疫治疗前组的单药化疗（27.0%）和一线免疫治疗后组的帕博利珠单抗（26.0%）。一线免疫治疗前组的中位总生存期为6.2个月（95%置信区间5.5-7.4），一线免疫治疗后组为8.9个月（95%置信区间7.5-10.6），而真实世界无进展生存期分别为3.7个月（95%置信区间3.3-4.2）和4.7个月（95%置信区间3.9-5.7）。
即使只有一小部分患者接受了一线免疫治疗，数据显示一线免疫治疗后组的生存结果有所改善。
