ConcertAI, LLC, 1120 Massachusetts, Ave., Cambridge, MA 02138, USA.
Merck & Co., Inc., 126 East Lincoln Avenue, P.O. Box 2000, Rahway, NJ 07065, USA.
Cancer Treat Res Commun. 2024;39:100800. doi: 10.1016/j.ctarc.2024.100800. Epub 2024 Feb 25.
To characterize the real-world treatment patterns and outcomes of patients with high-risk locally advanced cervical cancer (HR-LACC).
This retrospective study identified and randomly selected adults diagnosed between 2010 and 2018 from the ConcertAI Oncology Dataset. For patients initially treated with concurrent chemoradiotherapy (CCRT), we estimated real-world progression-free survival (rwPFS) among those with persistent disease, real-world time on CCRT, and recurrence-free survival (rwRFS) using Kaplan-Meier methods.
The cohort included 300 patients. Median age at diagnosis was 51 years. 53.7 % were White and 30.0 % were Black; 52.0 % were premenopausal; 89.3 % had squamous cell histology; 75.3 % had stage III disease, and 92.7 % had no evidence of performance status impairment. Initial treatment included CCRT (N = 229), surgery (N = 28), antineoplastics only (N = 11), and radiation only (N = 5). Twenty-seven patients were untreated. Baseline characteristics for the CCRT-first patients were similar to the overall cohort; their median real-world time on treatment was 1.6 months; 78.2 % received cisplatin for a median of 1.2 months; 28.4 % received antineoplastics after CCRT, and 11.8 % initiated a second antineoplastic therapy. Of the CCRT-first patients, 27/143 with a complete response had subsequent recurrent disease (median rwRFS not reached). 179 patients had persistent disease, among whom median (95 % confidence interval [CI]) rwPFS was 29.7 (16.9-59.3) months.
In this study of United States-based clinical practices, most HR-LACC patients received CCRT as initial treatment. Many patients developed persistent disease after CCRT indicating a need for improved first treatment and maintenance options.
描述高危局部晚期宫颈癌（HR-LACC）患者的真实世界治疗模式和结局。
本回顾性研究从 ConcertAI 肿瘤学数据集确定并随机选择了 2010 年至 2018 年间诊断的成年人。对于最初接受同期放化疗（CCRT）治疗的患者，我们使用 Kaplan-Meier 方法估计持续性疾病患者的真实世界无进展生存期（rwPFS）、CCRT 实际时间和无复发生存期（rwRFS）。
该队列包括 300 名患者。中位诊断年龄为 51 岁。53.7%为白人，30.0%为黑人；52.0%为绝经前；89.3%为鳞状细胞组织学；75.3%为 III 期疾病，92.7%无功能状态损害证据。初始治疗包括 CCRT（N=229）、手术（N=28）、仅用抗肿瘤药物（N=11）和仅放疗（N=5）。27 名患者未接受治疗。CCRT 一线治疗患者的基线特征与总体队列相似；他们的中位实际治疗时间为 1.6 个月；78.2%接受顺铂治疗，中位时间为 1.2 个月；28.4%在 CCRT 后接受抗肿瘤药物治疗，11.8%开始接受第二种抗肿瘤治疗。在 CCRT 一线治疗的患者中，143 例完全缓解的患者中有 27 例随后出现疾病复发（中位 rwRFS 未达到）。179 名患者有持续性疾病，其中 rwPFS 中位数（95%置信区间[CI]）为 29.7（16.9-59.3）个月。
在这项基于美国临床实践的研究中，大多数 HR-LACC 患者接受 CCRT 作为初始治疗。许多患者在 CCRT 后出现持续性疾病，这表明需要改进一线治疗和维持治疗方案。
