法国晚期和转移性肺癌的治疗模式与结局：法国流行病学策略与医疗经济学（ESME）数据库肺癌研究结果
Treatment patterns and outcomes in advanced and metastatic lung cancer in France: Results from the Epidemiological Strategy and medical Economics (ESME) database lung cancer in France.
作者
作者单位
- Institut Curie, Paris, France; UVSQ, UFR Simone Veil, Paris Saclay University, Versailles, France. Electronic address: nicolas.girard2@curie.fr.
- Institut Curie, Paris, France.
- Unicancer, Paris, France.
- Groupe Hospitalier Région Mulhouse et Sud Alsace, Mulhouse, France.
- Institut régional du Cancer Montpellier, Montpellier, France.
- Centre Hospitalier Toulon - Sainte-Musse, Toulon, France.
- Centre Hospitalier Universitaire de Rennes, Rennes, France.
- Oncopole Claudius Regaud IUCT-O, Toulouse, France.
- Centre François Baclesse, Caen, France.
- Institut de Cancérologie Strasbourg Europe, Strasbourg, France.
- Gustave Roussy, Villejuif, France.
- CHU, Angers, France.
- Centre Hospitalier Intercommunal de Créteil, Créteil, France.
- Centre Léon Bérard, Lyon, France.
摘要
中文
肺癌是癌症相关死亡的主要原因，近期治疗模式发生了转变，包括优化分期、识别可接受靶向治疗的分子亚型，以及免疫治疗取代化疗成为治疗基石。流行病学策略与医疗经济学（ESME）研究项目的肺癌部分旨在收集自2015年以来法国38家医疗机构网络中所有连续治疗的肺癌患者的个体数据。主要目标包括描述数据库中诊断为肺癌患者的治疗模式和结局。使用Logrank检验和Cox比例风险模型进行总生存期的单变量和多变量分析。在纳入晚期和转移性肺癌（AMLC）队列的52,514例患者中，45,232例（86%）为非小细胞肺癌（NSCLC），6,301例（12%）为小细胞肺癌（SCLC）。其中，NSCLC队列34%和SCLC队列42%的患者未接受二线治疗。在NSCLC队列中，从2020年起，免疫检查点抑制剂（ICI）为基础的方案成为最常用的一线选择。中位随访58.1（95%CI 57.1-59.0）个月后，NSCLC患者的中位OS为15.7（95%CI 15.4-16.0）个月，SCLC患者为11.0（95%CI 10.7-11.3）个月。多变量分析中，年龄、分期、NSCLC组织学亚型以及性别、ECOG体能状态和脑转移的存在与OS显著相关（NSCLC和SCLC均如此）。ESME数据库提供了法国肺癌管理的现实概况，以及真实世界中治疗模式的可靠评估，这构成了补充临床试验证据的重要资料，并强调了治疗顺序中未满足的需求。
English
Lung cancer is the main cause of cancer-related death, with recent paradigm shifts including optimized staging, identification of molecular subsets with access to targeted agents, and replacement of chemotherapy by immunotherapy as the backbone of treatment. The Lung Cancer part of the Epidemiological Strategy and Medical Economics (ESME) research program was launched to collect individual data from all consecutive patients treated for lung cancer since 2015 in a network of 38 health facilities in France. Main objectives included the description of the treatment patterns and outcomes of patients diagnosed with lung cancer in the database. Univariable and multivariable analyses on overall survival were performed using the Logrank test and the Cox proportional hazards model. Among 52,514 patients included in the advanced and metastatic lung cancer (AMLC) cohort, 45,232 (86%) had non-small cell lung cancer (NSCLC), and 6,301 (12%) had small-cell lung cancer (SCLC). Among those, 34% in the NSCLC cohort and 42% in the SCLC cohort did not receive second-line. In the NSCLC cohort, immune checkpoint inhibitor (ICI)-based therapies became the most commonly used first-line option from 2020 onwards. After a median follow-up of 58.1 (95%CI 57.1-59.0) months, the median OS was 15.7 (95%CI 15.4-16.0) months for patients with NSCLC, and 11.0 (95%CI 10.7-11.3) months for those with SCLC. At multivariable analyses, age, stage, histologic subtype for NSCLC remained significantly associated with OS, as well as gender, ECOG performance status and presence of brain metastases, both for NSCLC and SCLC. The ESME database provides a realistic overview of lung cancer management in France and a reliable assessment of treatment patterns in real-world setting, which constitutes essential evidence to complement data from clinical trials, and highlights unmet needs in treatment sequences.
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