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. 2024 Jul 10;24(1):332.
doi: 10.1186/s12890-024-03138-y.

A retrospective analysis of treatment patterns, overall survival, and real-world disease-free survival in early-stage non-small cell lung cancer following complete resection

Xiaohan Hu  1 , Diana Chirovsky  2 , Mark S Walker  3 , Yuexi Wang  3 , Alpana Kaushiva  3 , Jon Tepsick  3 , Ayman Samkari  2
Affiliations

A retrospective analysis of treatment patterns, overall survival, and real-world disease-free survival in early-stage non-small cell lung cancer following complete resection

Xiaohan Hu et al. BMC Pulm Med. .

Abstract

Background: Real-world data regarding patient characteristics, adjuvant treatment patterns, and long-term survival outcomes are needed to better understand unmet needs among patients with completely resected early-stage non-small cell lung cancer (NSCLC).

Methods: Electronic medical records from the U.S.-based ConcertAI Patient360™ database were analyzed in patients with stage IB-IIIA NSCLC who underwent complete resection prior to March 1, 2016. Patients were followed until death or July 1, 2021. This study evaluated adjuvant chemotherapy use, and overall survival (OS) and real-world disease-free survival (rwDFS) outcomes using the Kaplan-Meier method. The correlation between OS and rwDFS was assessed using the Kendall rank test. Among patients who did not recur 5 years following surgery, landmark analyses of OS and rwDFS were conducted to understand the subsequent survival impact of remaining disease-free for at least 5 years.

Results: Data from 441 patients with completely resected stage IB-IIIA NSCLC were included. About 35% of patients received adjuvant chemotherapy post-resection. Median OS and rwDFS from resection were 83.1 months and 42.4 months, respectively. The 5-year OS and rwDFS rates were 65.7% and 42.1%, respectively. OS and rwDFS were positively correlated (Kendall rank correlation coefficient = 0.67; p < 0.0001). Among patients without recurrence within 5 years after resection, the subsequent 5-year OS and rwDFS survival rates were 52.9% and 36.6%, respectively.

Conclusions: Use of adjuvant chemotherapy was low, and the overall 5-year OS rate remained low despite all patients having undergone complete resection. Patients who remained non-recurrent over time had favorable subsequent long-term survival.

Keywords: Adjuvant chemotherapy; Complete resection; Early-stage NSCLC; Real-world clinical outcomes; Recurrence.

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Conflict of interest statement

XH, DC, and AS are employed by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and hold stock or stock options in Merck & Co., Inc., Rahway, NJ, USA.

MSW, YW, AK, and JT report research funding to their institution from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.

Figures

Fig. 1
Fig. 1
Duration of first adjuvant therapy for patients with completely resected stage IB-IIIA NSCLC who received adjuvant systemic therapy A cycle is estimated as a treatment duration of approximately 21 days
Fig. 2
Fig. 2
Kaplan–Meier analysis of overall survival from complete resection for patients with stage IB-IIIA OS, overall survival
Fig. 3
Fig. 3
Kaplan–Meier analysis of real-world disease-free survival from complete resection for patients with stage IB-IIIA rwDFS, real-world disease-free survival
See this image and copyright information in PMC

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