J Thorac Oncol. 2021 May 26:S1556-0864(21)02174-2. doi: 10.1016/j.jtho.2021.05.003. Online ahead of print.
ABSTRACT
INTRODUCTION: Stage III non-small cell lung cancer (NSCLC) is a heterogeneous disease requiring a multi-modal management approach. We conducted a real-world, global study to characterise patients, treatment patterns, and their associated clinical outcomes for stage III NSCLC.
METHODS: KINDLE was a retrospective study in patients with stage III NSCLC (American Joint Committee on Cancer, 7th edition) diagnosed between January 2013 and December 2017, with at least nine months of documented follow-up since index diagnosis. In addition to descriptive statistics, Kaplan-Meier methodology evaluated survival estimates; two-sided 95% confidence interval (CI) intervals were computed. Cox proportional hazard model was used for univariate and multi-variate analyses.
RESULTS: A total of 3151 patients from more than 100 centres across 19 countries from Asia, Middle East and Africa, and Latin America were enrolled. Median age was 63.0 years (range 21.0-92.0); 76.5% were males, 69.2% had a smoking history, 53.7% had adenocarcinoma and 21.4% underwent curative resection. Of >25 treatment regimens, concurrent chemoradiotherapy (cCRT) was the most common (29.4%). The overall median progression-free survival (mPFS; 95% CI) and median overall survival (mOS) were 12.5 months (12.06-13.14) and 34.9 months (32.00-38.01), respectively. Significant associations (p<0.05) were observed for mPFS and mOS with respect to gender, region, smoking status, stage, histology, and Eastern Cooperative Oncology Group (ECOG) status. In univariate and multi-variate analyses, younger age, stage IIIA, better ECOG status, cCRT, and surgery as initial therapy predicted better mOS.
CONCLUSIONS: KINDLE reveals the diversity in treatment practices and outcomes in stage III NSCLC in a real-world setting in the pre-immuno-oncology era. There is a high unmet medical need, necessitating novel approaches to optimise outcomes.
PMID:34051381 | DOI:10.1016/j.jtho.2021.05.003
