治疗演变:美国新批准的系统治疗在已切除的IB-IIIA期非小细胞肺癌中的应用
Therapeutic evolution: Adoption of newly approved systemic therapies in resected stage IB-IIIA NSCLC in the United States.
作者
作者单位
- H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States. Electronic address: jhanelle.gray@moffitt.org.
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, United States. Electronic address: thoele_kelli@lilly.com.
- Flatiron Health, 233 Spring Street, New York, NY 10013, United States. Electronic address: madeline.richey@flatiron.com.
- Flatiron Health, 233 Spring Street, New York, NY 10013, United States. Electronic address: nada.boualam@flatiron.com.
- Flatiron Health, 233 Spring Street, New York, NY 10013, United States. Electronic address: karen.schwed@flatiron.com.
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, United States. Electronic address: erich.brechtelsbauer@lilly.com.
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, United States. Electronic address: ma_qinli@lilly.com.
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, United States. Electronic address: sheffield_kristin_m@lilly.com.
摘要
中文
关于免疫治疗和靶向治疗在早期和局部晚期非小细胞肺癌(NSCLC)临床实践中应用的证据有限。这项回顾性、观察性队列研究使用美国肿瘤学实践的健康记录,描述了已切除的IB-IIIA期NSCLC患者的治疗模式并评估结局。纳入2019年1月至2023年12月期间完成主要手术的成年IB-IIIA期NSCLC患者(n=14,638),潜在随访至2024年8月。还对II-IIIA期NSCLC患者(n=9,932)进行了亚组分析。按分期、生物标志物状态和手术年份描述了新辅助和辅助治疗的使用情况。结局包括无病生存期(DFS)和总生存期(OS)。在14,638例患者中(中位年龄70岁),32.1%诊断为IB期,39.2%为II期,28.6%为III期。研究期间,58.3%接受了任何系统治疗(47.7%铂类化疗,18.1%免疫治疗,4.9%靶向治疗),主要是在辅助治疗阶段。免疫治疗和奥希替尼的使用随时间增加:到2023年,48.6%的II-IIIA期患者接受免疫治疗,58.0%的IB-IIIA期EGFR突变NSCLC患者接受奥希替尼。总研究队列的中位DFS为46.2个月,II-IIIA期患者为38.4个月。总研究队列的3年OS为72.9%。随着近期获批,早期和局部晚期NSCLC的治疗格局迅速演变。来自大型临床实践研究的真实世界数据在理解新治疗的使用和结局以及识别潜在临床实践差距和未满足需求方面具有价值。
English
Evidence is limited regarding use of immunotherapies and targeted therapies in early-stage and locally advanced non-small cell lung cancer (NSCLC) in clinical practice. This retrospective, observational cohort study used health records from US oncology practices to describe treatment patterns and evaluate outcomes in patients with resected stage IB-IIIA NSCLC. Adult patients with stage IB-IIIA NSCLC who completed primary surgery from January 2019-December 2023 (n = 14,638) were included, with potential follow-up through August 2024. Subset analyses of stage II-IIIA NSCLC (n = 9,932) were also conducted. Neoadjuvant and adjuvant therapy use was described by stage, biomarker status, and year of surgery. Outcomes included disease-free survival (DFS) and overall survival (OS). Among 14,638 patients (median age, 70 years) 32.1 % were diagnosed with stage IB, 39.2 % with stage II, and 28.6 % with stage III disease. During the study period, 58.3 % received any systemic treatment (47.7 % platinum-based chemotherapy, 18.1 % immunotherapy, and 4.9% targeted therapy), primarily in the adjuvant setting. Immunotherapy and osimertinib use increased over time: by 2023, 48.6 % of patients with stage II-IIIA disease received immunotherapy, and 58.0 % of patients with stage IB-IIIA EGFR-mutant NSCLC received osimertinib. Median DFS was 46.2 months for overall study cohort and 38.4 months for patients with stage II-IIIA disease. The 3-year OS was 72.9 % for the overall study cohort. The treatment landscape for early-stage and locally advanced NSCLC has rapidly evolved with recent approvals. Real-world data from large clinical practice studies provide value in understanding use and outcomes of new treatments and identifying potential clinical practice gaps and unmet need.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q1
- 影响因子
- 5.3
- 新锐分区
- 2区