Trends in the prescription of systemic anticancer therapy and mortality among patients with advanced non-small cell lung cancer: a real-world retrospective observational cohort study from the I-O optimise initiative. Issue 5 (3rd May 2021)

• Record Type: Journal Article
• Authors: Snee, Michael; Cheeseman, Sue; Thompson, Matthew; Riaz, Majid; Sopwith, Will; Lacoin, Laure; Chaib, Carlos; Manley Daumont, Melinda; Penrod, John R; O'Donnell, John C; Hall, Geoff
• Is Part Of: BMJ open. Volume 11:Issue 5(2021)
• Publication Date: 2021-05-03
• Subjects: chemotherapy -- epidemiology -- oncology -- respiratory tract tumours -- thoracic medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-043442
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To assess how a decade of developments in systematic anticancer therapy (SACT) for advanced non-small cell lung cancer (NSCLC) affected overall survival (OS) in a large UK University Hospital. Design: Real-world retrospective observational cohort study using existing data recorded in electronic medical records. Setting: A large National Health Service (NHS) university teaching hospital serving 800 000 people living in a diverse metropolitan area of the UK. Participants: 2119 adults diagnosed with advanced NSCLC (tumour, node, metastasis stage IIIB or IV) between 2007 and 2017 at Leeds Teaching Hospitals NHS Trust. Main outcomes and measures: OS following diagnosis and the analysis of factors associated with receiving SACT. Results: Median OS for all participants was 2.9 months, increasing for the SACT-treated subcohort from 8.4 months (2007–2012) to 9.1 months (2013–2017) (p=0.02); 1-year OS increased from 33% to 39% over the same period for the SACT-treated group. Median OS for the untreated subcohort was 1.6 months in both time periods. Overall, 30.6% (648/2119) patients received SACT; treatment rates increased from 28.6% (338/1181) in 2007–2012 to 33.0% (310/938) in 2013–2017 (p=0.03). Age and performance status were independent predictors for SACT treatment; advanced age and higher performance status were associated with lower SACT treatment rates. Conclusion: Although developments in SACT during 2007–2017 correspond to some changes in survival for treated patients with advanced NSCLC, treatment rates remain low and the prognosis for all patients remains poor.