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Treatment Patterns and Outcomes in Resected Early-stage Non-small Cell Lung Cancer: An Analysis of the SEER-Medicare Data
Journal article   Open access   Peer reviewed

Treatment Patterns and Outcomes in Resected Early-stage Non-small Cell Lung Cancer: An Analysis of the SEER-Medicare Data

Howard West, Xiaohan Hu, Su Zhang, Yan Song, Diana Chirovsky, Chi Gao, Ariel Lerner, Anya Jiang, James Signorovitch and Ayman Samkari
Clinical lung cancer, v 24(3), pp 260-268
May 2023
DOI: https://doi.org/10.1016/j.cllc.2022.12.005
PMID: 36641325
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.cllc.2022.12.005View
Published, Version of Record (VoR) Open

Abstract

Adjuvant treatment NSCLC Overall survival Real-world disease-free survival Recurrence
As the non-small cell lung cancer (NSCLC) adjuvant treatment landscape evolves, an evaluation of treatment patterns and outcomes of patients with early-stage, resected NSCLC eligible for adjuvant treatment in routine clinical practice is needed to better understand the unmet needs in this patient population. Data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2007-2019) were used to identify patients with newly diagnosed stage IB (tumor size ≥4cm)-IIIA (AJCC 7th edition) NSCLC who received primary surgery (index date). We assessed adjuvant treatment patterns, real-world disease-free survival (rwDFS; time from index date to first recurrence or death) and overall survival (OS; time from index date to death), and loco-regional recurrence pattern and treatment distribution. Among 1761 patients with primary surgery, mean age was 73.8 years; 47.9% were male; and 83.9% were white. Approximately 41% of patients received adjuvant chemotherapy; median time from surgery to adjuvant chemotherapy initiation was 48 days, and the most frequently observed adjuvant chemotherapy regimen was carboplatin+paclitaxel (24.5%). In the overall population, median rwDFS was 24.8 months and OS was 76.7 months; 5-year rwDFS and OS rates were 29.3% and 57.5%, respectively. Among 392 patients with loco-regional recurrence, the most frequently observed treatment was curative radiation monotherapy (28.2%). Despite clinical guideline recommendations, rate of adjuvant chemotherapy among patients with resected early-stage NSCLC was low in clinical practice. Overall, among patients with early-stage NSCLC treated with conventional primary surgery, poor survival outcomes were observed, highlighting the need for and importance of more effective adjuvant treatments. This study aimed to identify unmet needs of patients with early-stage, resected NSCLC using the SEER-Medicare database (2007-2019). Among 1761 patients included, 40.6% received adjuvant chemotherapy and two-thirds experienced disease recurrence during 4.5 years of follow-up. At 5 years, only 29.3% remained disease-free and 57.5% were alive. These findings highlight the need for more effective adjuvant treatment options.

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Web of Science research areas
Oncology
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