Metastatic NSCLC: Clinical, molecular, and therapeutic factors associated with long-term survival

• Published in: Respiratory medicine and research 2019-11, Vol.76, p.38-44
• Main Authors: Asselain, B., Barrière, J.-R., Clarot, C., Vabre, J.-P., Gentil Le Pecq, B., Duval, Y., Thomas, P., Herman, D., Grivaux, M., Debieuvre, D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor - genetics; Cancer survivors; Carcinoma; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - therapy; Female; France - epidemiology; General hospitals; Genetic Predisposition to Disease; Humans; Lung Neoplasms - genetics; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Non-small-cell lung; Observational study; Prognosis; Prognosis factors; Risk Factors; Survival Analysis
• ISSN: 2590-0412; 2590-0412
• DOI: 10.1016/j.resmer.2019.07.001

Patients with metastatic non-small-cell lung cancer (NSCLC) who survive more than 2 years are considered long-term survivors (LTSs). The present study examined factors associated with long-term survival and collected information for future comparison. Clinical, molecular, and therapeutic data were collected from patients followed for primary stage IV (7th TNM classification) NSCLC within 2 years from diagnosis in the respiratory medicine departments of 53 French non-teaching hospitals. LTS and non-LTS records were compared. Factors associated with long-term survival were examined by univariate and multivariate analyses using logistic regression models. Vital status at least 2 years after diagnosis was known for 1977 stage IV NSCLC patients; 220 (11.1%) were LTSs. On multivariate analysis, independent positive factors comprised: TTF-1(+) immunochemistry, EGFR-mutation, surgery, rescue radiotherapy, and targeted therapy. Independent negative factors comprised: prediagnosis weight loss>5kg, ECOG performance status>1, and primary radiotherapy. Molecular biology and targeted therapy were decisive for long-term survival. With their development and their widespread implementation in clinical practice, the percentage of LTSs is expected to grow. Factors determining long-term survival found in this study should be taken into account when considering treatment options for patients with stage IV NSCLC.