Much has changed in the last decade except overall survival: A Swiss single center analysis of treatment and survival in patients with stage IV non-small cell lung cancer

Molecular therapies for cancers with targetable driver mutations and immunotherapies have revolutionized treatment of non-small cell lung cancer (NSCLC) during the last decade. International treatment guidelines began integrating targeted therapies in 2009 and immunotherapies in 2015. The aim of thi...

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Bibliographic Details
Published in:PloS one 2020-05, Vol.15 (5), p.e0233768-e0233768
Main Authors: Wallrabenstein, Till, Del Rio, Jessica, Templeton, Arnoud J, Buess, Martin
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Cancer therapies
Cancer treatment
Cell survival
Chemotherapy
Clinical trials
Drug therapy
Forecasts and trends
Histology
Hospitals
Immunotherapy
Lung cancer
Lung diseases
Medical diagnosis
Medical prognosis
Medicine
Medicine and Health Sciences
Metastasis
Morbidity
Mortality
Mutation
Non-small cell lung cancer
Non-small cell lung carcinoma
Oncology
Patient outcomes
Patients
Rank tests
Small cell lung carcinoma
Subgroups
Survival
Tumors
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Summary:Molecular therapies for cancers with targetable driver mutations and immunotherapies have revolutionized treatment of non-small cell lung cancer (NSCLC) during the last decade. International treatment guidelines began integrating targeted therapies in 2009 and immunotherapies in 2015. The aim of this study was to examine whether the benefits described for these new therapies in pivotal phase III trials have been translated to a real world patient population. Data from all consecutive patients diagnosed with stage IV NSCLC diagnosed at a community hospital in Switzerland between 2007 and 2018 were analyzed. Three groups of patients were compared, namely patients diagnosed before 2009 (group 1), between 2009 and 2015 (introduction of targeted therapies, group 2) and after 2015 (introduction of immunotherapies, group 3). The primary outcome was overall survival (OS). Time to treatment failure was a secondary outcome. Both endpoints were estimated using the Kaplan Meyer method and compared by log-rank test. 408 patients were included. Patient characteristics were similar in the three groups. Median OS in groups 1, 2, and 3 was 9.8 (95% CI, 6.2 to 13.4), 9.9 (95% CI, 7.6 to 12.1) and 8.6 (95% CI, 6.6 to 10.5) months, respectively (p = 0.5). Across groups patients treated with targeted- and immunotherapies had a significantly better outcome than those treated with chemotherapy or best supportive care (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0233768