{"title":"Improvement in Survival in Patients With Advanced Non-small Cell Lung Cancer.","authors":"Keishi Yoshida, Kaoru Watanabe, Taku Nishimura, Hiroaki Ikushima, Sayaka Ohara, Hideyuki Takeshima, Toshio Sakatani, Kazuhiro Usui","doi":"10.21873/anticanres.17417","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>New treatment agents for advanced non-small cell lung carcinoma (NSCLC) have improved overall survival (OS) in the last 20 years. Nevertheless, treatment strategies for patients with NSCLC and pulmonary fibrosis have not yet been established. This study aimed to evaluate OS improvement in patients with stage IV NSCLC based on the underlying pulmonary diseases.</p><p><strong>Patients and methods: </strong>This study retrospectively reviewed 581 patients with stage IV NSCLC who received any antineoplastic agents. Patients were categorized into three groups based on their underlying pulmonary conditions: normal lungs, emphysema, and fibrosis. Additionally, patients were divided into four periods: A (2002-2006), B (2007-2011), C (2012-2016), and D (2017-2021). OS of patients with each underlying pulmonary disease was compared across the different periods and treatment agents [cytotoxic agents (CYs) only, molecular-targeted tyrosine kinase inhibitors (TKIs), and immune checkpoint inhibitors (ICIs)].</p><p><strong>Results: </strong>Emphysema and fibrosis were identified in 205 (35.3%) and 54 (9.3%) patients, respectively. Over the last two decades, the OS (months) of all patients improved (p<0.001), including patients with normal lungs (p=0.004) and patients with emphysema (p<0.001), but with no significant improvement in fibrosis (p=0.605). TKI and ICI improved OS in patients with normal lungs (p<0.001) and emphysema (p<0.001), but had no significant impact on OS in patients with fibrosis (p=0.502).</p><p><strong>Conclusion: </strong>Patients with advanced NSCLC have improved prognoses in the last 20 years except for patients with pulmonary fibrosis. To improve the prognosis of patients with lung cancer and pulmonary fibrosis, new strategies and treatments should be developed.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":"45 1","pages":"295-305"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17417","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background/aim: New treatment agents for advanced non-small cell lung carcinoma (NSCLC) have improved overall survival (OS) in the last 20 years. Nevertheless, treatment strategies for patients with NSCLC and pulmonary fibrosis have not yet been established. This study aimed to evaluate OS improvement in patients with stage IV NSCLC based on the underlying pulmonary diseases.
Patients and methods: This study retrospectively reviewed 581 patients with stage IV NSCLC who received any antineoplastic agents. Patients were categorized into three groups based on their underlying pulmonary conditions: normal lungs, emphysema, and fibrosis. Additionally, patients were divided into four periods: A (2002-2006), B (2007-2011), C (2012-2016), and D (2017-2021). OS of patients with each underlying pulmonary disease was compared across the different periods and treatment agents [cytotoxic agents (CYs) only, molecular-targeted tyrosine kinase inhibitors (TKIs), and immune checkpoint inhibitors (ICIs)].
Results: Emphysema and fibrosis were identified in 205 (35.3%) and 54 (9.3%) patients, respectively. Over the last two decades, the OS (months) of all patients improved (p<0.001), including patients with normal lungs (p=0.004) and patients with emphysema (p<0.001), but with no significant improvement in fibrosis (p=0.605). TKI and ICI improved OS in patients with normal lungs (p<0.001) and emphysema (p<0.001), but had no significant impact on OS in patients with fibrosis (p=0.502).
Conclusion: Patients with advanced NSCLC have improved prognoses in the last 20 years except for patients with pulmonary fibrosis. To improve the prognosis of patients with lung cancer and pulmonary fibrosis, new strategies and treatments should be developed.
背景/目的：在过去的20年里，晚期非小细胞肺癌（NSCLC）的新治疗药物提高了总生存率（OS）。然而，对于非小细胞肺癌和肺纤维化患者的治疗策略尚未确定。本研究旨在评估基于基础肺部疾病的IV期NSCLC患者的OS改善情况。患者和方法：本研究回顾性回顾了581例接受抗肿瘤药物治疗的IV期非小细胞肺癌患者。患者根据其潜在的肺部状况分为三组：正常肺、肺气肿和纤维化。此外，将患者分为四个阶段：A (2002-2006), B (2007-2011)， C（2012-2016）和D（2017-2021）。比较了不同时期和不同治疗药物（仅细胞毒性药物（CYs）、分子靶向酪氨酸激酶抑制剂（TKIs）和免疫检查点抑制剂（ICIs））对每种肺部疾病患者的OS的影响。结果：肺气肿205例（35.3%），纤维化54例（9.3%）。在过去的20年里，所有患者的OS（月）都得到了改善(结论：在过去的20年里，晚期NSCLC患者的预后得到了改善，除了肺纤维化患者。为了改善肺癌合并肺纤维化患者的预后，需要制定新的策略和治疗方法。
期刊介绍：
ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed.
ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies).
Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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