Prabhash Kumar, Moor Rebecca, Göksel Tuncay, Nyaw Jonathan, Altwairgi Abdullah Khalaf, Gonzalez Francisco, Mohamed Elsayed, Kantharaju Pushpalatha, Sadek Farah
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Mater Cancer Care Centre & Medical Oncology Research, South Brisbane, Australia.
Thorac Cancer. 2025 Apr;16(8):e70061. doi: 10.1111/1759-7714.70061.
THASSOS-INTL (NCT04808050), a multinational, retrospective study, evaluated treatment patterns and associated outcomes in patients with early-stage non-small cell lung cancer (NSCLC) from seven countries in the Asia-Pacific and the Middle-East and Africa.
Eligible adult patients (≥ 18 years) with resectable clinical stage (CS) IA-IIIB NSCLC (7th AJCC) diagnosed from 01/01/2013 to 31/12/2017 were followed until death, last recorded clinical visit, or 31/12/2020 (data cut-off).
Of 755 patients (CS I: 30.6%, CS II: 35.0%, CS III: 34.2%) with a median age of 62 [range: 56-69] years enrolled, 69.3% were male, and 75.0% were current/ex-smokers. Of 24.2% of patients tested for EGFR, 28.4% (52/183) were positive, while 23/44 patients tested (52.3%) had PD-L1 expression (≥ 1%: 16; unknown: 7). Overall, 82.9% had surgery, of whom 39.1% (245/626) had surgery alone; 21.1% received neoadjuvant therapy, 51.1% received adjuvant therapy, and 5.8% received both; 11.2% (58/519) patients received targeted therapy (adjuvant: 47 patients; neoadjuvant: 11 patients), and 4.6% (24/519) received immunotherapy (adjuvant: 22 patients; neoadjuvant: 2 patients). The 3-year survival was 77.4% with a median overall survival (mOS) of 7.5 (95% confidence interval [CI]: 6.7-NE) years, with the highest mOS recorded with adjuvant therapy (7.5 [95% CI: 7.0-NE] years).
This real-world study showed > 50% use of adjuvant therapy per guideline recommendations but poor use of neoadjuvant therapy. Biomarker testing at diagnosis was low, reflecting the study period being before targeted and immunotherapies. With recent approvals of newer (neo)adjuvant agents, a multidisciplinary approach is needed for better treatment decisions to improve the prognosis of early-stage NSCLC.
THASSOS-INTL（NCT04808050）是一项多国回顾性研究，评估了亚太地区以及中东和非洲七个国家的早期非小细胞肺癌（NSCLC）患者的治疗模式及相关预后。
纳入2013年1月1日至2017年12月31日期间诊断为可切除临床分期（CS）IA-IIIB期NSCLC（第7版美国癌症联合委员会分期系统）的符合条件的成年患者（≥18岁），随访至死亡、最后一次记录的临床访视或2020年12月31日（数据截止）。
共纳入755例患者（CS I期：30.6%，CS II期：35.0%，CS III期：34.2%），中位年龄为62岁[范围：56 - 69岁]，69.3%为男性，75.0%为现吸烟者或既往吸烟者。在接受EGFR检测的患者中，24.2%检测结果为阳性，其中28.4%（52/183）为阳性；44例接受检测的患者中有23例（52.3%）有PD-L1表达（≥1%：16例；情况不明：7例）。总体而言，82.9%的患者接受了手术，其中39.1%（245/626）仅接受了手术；21.1%接受了新辅助治疗，51.1%接受了辅助治疗，5.8%同时接受了两者；11.2%（58/519）患者接受了靶向治疗（辅助治疗：47例患者；新辅助治疗：11例患者），4.6%（24/519）接受了免疫治疗（辅助治疗：22例患者；新辅助治疗：2例患者）。3年生存率为77.4%，中位总生存期（mOS）为7.5年（95%置信区间[CI]：6.7 - 未估计），辅助治疗的mOS最高（7.5年[95%CI：7.0 - 未估计]）。
这项真实世界研究表明，按照指南建议，超过50%的患者使用了辅助治疗，但新辅助治疗的使用率较低。诊断时的生物标志物检测率较低，这反映了研究期间在靶向治疗和免疫治疗之前。随着近期新型（新）辅助药物的获批，需要采用多学科方法来做出更好的治疗决策，以改善早期NSCLC的预后。
