Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China.
College of Basic Medicine, Zhengzhou University, Zhengzhou, China.
Clin Respir J. 2024 Sep;18(9):e70000. doi: 10.1111/crj.70000.
Immunotherapy has revolutionized the management of lung cancer and improved lung cancer survival in trials, but its real-world impact at the population level remains unclear.
Using data obtained from eight Surveillance, Epidemiology, and End Results (SEER) registries from 2004 through 2019, we addressed the long-term trends in the incidence, incidence-based mortality (IBM), and survival of lung cancer patients in the United States.
The incidence and IBM of both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) all significantly decreased steadily from 2004 to 2019. The 1-year survival (1-YS) of both NSCLC and SCLC improved over time, with the best improvement observed for Stage 4 NSCLC. Two significant turning points of Stage 4 NSCLC 1-YS were observed over the years: 0.63% (95% confidence interval [CI]: 0.33%-0.93%) from 2004 to 2010, 0.81% (95% CI: 0.41%-1.21%) from 2010 to 2014 and a striking 2.09% (95% CI: 1.70%-2.47%) from 2014 to 2019. The same two turning points in 1-YS were pronounced for Stage 4 NSCLC in women, which were coincident with the introduction of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and immunotherapy. However, for Stage 4 NSCLC in men, only one significant turning point in the 1-YS starting in 2014 was found, which might only correspond to immunotherapy. Significant period effects in reduced IBM were also observed for both Stage 4 AD and Stage 4 SQCC during the period.
This SEER analysis found that immunotherapy improved the survival of Stage 4 NSCLC patients at the population level in the United States. This real-world evidence confirms that immunotherapy has truly revolutionized the management of lung cancer.
免疫疗法彻底改变了肺癌的治疗方式，并在临床试验中提高了肺癌患者的生存率，但免疫疗法在人群层面的实际影响仍不清楚。
我们利用 2004 年至 2019 年期间从 8 个监测、流行病学和最终结果（SEER）登记处获得的数据，探讨了美国肺癌患者的发病率、发病率死亡率（IBM）和生存率的长期趋势。
非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）的发病率和 IBM 均从 2004 年到 2019 年持续稳定下降。NSCLC 和 SCLC 的 1 年生存率（1-YS）随时间推移而提高，其中 4 期 NSCLC 的改善最为显著。在这几年中，我们观察到 4 期 NSCLC 1-YS 有两个重要的转折点：2004 年至 2010 年为 0.63%（95%置信区间[CI]：0.33%-0.93%），2010 年至 2014 年为 0.81%（95%CI：0.41%-1.21%），2014 年至 2019 年为 2.09%（95%CI：1.70%-2.47%）。同样，女性 4 期 NSCLC 的 1-YS 也出现了这两个转折点，这与表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）和免疫疗法的引入相一致。然而，对于男性 4 期 NSCLC，仅在 2014 年发现了一个 1-YS 的显著转折点，这可能仅与免疫疗法有关。在这一时期，4 期 AD 和 4 期 SQCC 的 IBM 也出现了显著的时期效应。
这项 SEER 分析发现，免疫疗法改善了美国人群中 4 期 NSCLC 患者的生存。这一真实世界的证据证实，免疫疗法确实彻底改变了肺癌的治疗模式。
