Immunotherapy Improves the Survival of Stage 4 Non–Small Cell Lung Cancer Patients at the US Population Level: The Real-World Evidence

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal Pub Date : 2024-09-14 DOI:10.1111/crj.70000

Yuxuan Wei, Rui Zhang, Ruikang Yin, Shijie Wang, Jianglong Han, Ruyan Chen, Zhenming Fu

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引用次数: 0

Abstract

Introduction

Immunotherapy has revolutionized the management of lung cancer and improved lung cancer survival in trials, but its real-world impact at the population level remains unclear.

Methods

Using data obtained from eight Surveillance, Epidemiology, and End Results (SEER) registries from 2004 through 2019, we addressed the long-term trends in the incidence, incidence-based mortality (IBM), and survival of lung cancer patients in the United States.

Results

The incidence and IBM of both non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) all significantly decreased steadily from 2004 to 2019. The 1-year survival (1-YS) of both NSCLC and SCLC improved over time, with the best improvement observed for Stage 4 NSCLC. Two significant turning points of Stage 4 NSCLC 1-YS were observed over the years: 0.63% (95% confidence interval [CI]: 0.33%–0.93%) from 2004 to 2010, 0.81% (95% CI: 0.41%–1.21%) from 2010 to 2014 and a striking 2.09% (95% CI: 1.70%–2.47%) from 2014 to 2019. The same two turning points in 1-YS were pronounced for Stage 4 NSCLC in women, which were coincident with the introduction of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and immunotherapy. However, for Stage 4 NSCLC in men, only one significant turning point in the 1-YS starting in 2014 was found, which might only correspond to immunotherapy. Significant period effects in reduced IBM were also observed for both Stage 4 AD and Stage 4 SQCC during the period.

Conclusion

This SEER analysis found that immunotherapy improved the survival of Stage 4 NSCLC patients at the population level in the United States. This real-world evidence confirms that immunotherapy has truly revolutionized the management of lung cancer.

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免疫疗法提高了美国非小细胞肺癌 4 期患者的生存率：真实世界的证据

引言免疫疗法在肺癌治疗方面带来了革命性的变化，并在试验中提高了肺癌的生存率，但其在人群中的实际影响仍不清楚。方法我们利用从 2004 年到 2019 年的 8 个监测、流行病学和最终结果（SEER）登记处获得的数据，研究了美国肺癌患者的发病率、基于发病率的死亡率（IBM）和生存率的长期趋势。结果从 2004 年到 2019 年，非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）的发病率和 IBM 均显著稳步下降。随着时间的推移，非小细胞肺癌和小细胞肺癌的 1 年生存率（1-YS）都有所提高，其中第 4 期非小细胞肺癌的提高幅度最大。多年来，NSCLC 四期的 1 年生存率出现了两个重要转折点：2004年至2010年为0.63%（95%置信区间[CI]：0.33%-0.93%），2010年至2014年为0.81%（95%置信区间：0.41%-1.21%），2014年至2019年为惊人的2.09%（95%置信区间：1.70%-2.47%）。1-YS的两个转折点同样明显地出现在女性NSCLC四期患者中，这两个转折点与表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）和免疫疗法的引入相吻合。然而，在男性 NSCLC 4 期患者中，只发现了一个从 2014 年开始的 1-YS 显著转折点，这可能只与免疫疗法有关。在此期间，4 期 AD 和 4 期 SQCC 也观察到了 IBM 降低的显著时期效应。结论 SEER 的这项分析发现，在美国，免疫疗法在人群水平上提高了 NSCLC 4 期患者的生存率。这一真实世界的证据证实，免疫疗法确实为肺癌的治疗带来了革命性的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)