Real-World Treatment Patterns and Associated Outcomes in Patients With Resectable Early-Stage Non-Small Cell Lung Cancer: The THASSOS International Study.

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2025-04-01 DOI:10.1111/1759-7714.70061

Kumar Prabhash, Rebecca Moor, Tuncay Göksel, Jonathan Nyaw, Abdullah Khalaf Altwairgi, Francisco Gonzalez, Elsayed Mohamed, Pushpalatha Kantharaju, Farah Sadek

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Abstract

Background: THASSOS-INTL (NCT04808050), a multinational, retrospective study, evaluated treatment patterns and associated outcomes in patients with early-stage non-small cell lung cancer (NSCLC) from seven countries in the Asia-Pacific and the Middle-East and Africa.

Methods: Eligible adult patients (≥ 18 years) with resectable clinical stage (CS) IA-IIIB NSCLC (7th AJCC) diagnosed from 01/01/2013 to 31/12/2017 were followed until death, last recorded clinical visit, or 31/12/2020 (data cut-off).

Results: Of 755 patients (CS I: 30.6%, CS II: 35.0%, CS III: 34.2%) with a median age of 62 [range: 56-69] years enrolled, 69.3% were male, and 75.0% were current/ex-smokers. Of 24.2% of patients tested for EGFR, 28.4% (52/183) were positive, while 23/44 patients tested (52.3%) had PD-L1 expression (≥ 1%: 16; unknown: 7). Overall, 82.9% had surgery, of whom 39.1% (245/626) had surgery alone; 21.1% received neoadjuvant therapy, 51.1% received adjuvant therapy, and 5.8% received both; 11.2% (58/519) patients received targeted therapy (adjuvant: 47 patients; neoadjuvant: 11 patients), and 4.6% (24/519) received immunotherapy (adjuvant: 22 patients; neoadjuvant: 2 patients). The 3-year survival was 77.4% with a median overall survival (mOS) of 7.5 (95% confidence interval [CI]: 6.7-NE) years, with the highest mOS recorded with adjuvant therapy (7.5 [95% CI: 7.0-NE] years).

Conclusions: This real-world study showed > 50% use of adjuvant therapy per guideline recommendations but poor use of neoadjuvant therapy. Biomarker testing at diagnosis was low, reflecting the study period being before targeted and immunotherapies. With recent approvals of newer (neo)adjuvant agents, a multidisciplinary approach is needed for better treatment decisions to improve the prognosis of early-stage NSCLC.

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可切除的早期非小细胞肺癌患者的真实世界治疗模式和相关结果：THASSOS国际研究

背景：THASSOS-INTL （NCT04808050）是一项跨国回顾性研究，评估了来自亚太、中东和非洲7个国家的早期非小细胞肺癌（NSCLC）患者的治疗模式和相关结果。方法：对2013年1月1日至2017年12月31日诊断为可切除临床分期（CS） IA-IIIB NSCLC（第7 AJCC）的符合条件的成年患者（≥18岁）进行随访，直至死亡、最后一次临床访问记录或2020年12月31日（数据截止）。结果：纳入的755例患者（CS I: 30.6%, CS II: 35.0%, CS III: 34.2%）中位年龄为62岁[范围：56-69岁]，69.3%为男性，75.0%为当前/已戒烟者。在接受EGFR检测的24.2%的患者中，28.4%（52/183）呈阳性，而23/44（52.3%）的患者有PD-L1表达(≥1%:16；无名:7)。总体而言，82.9%的人接受了手术，其中39.1%（245/626）的人单独接受了手术；21.1%接受新辅助治疗，51.1%接受辅助治疗，5.8%同时接受新辅助治疗；11.2%（58/519）的患者接受了靶向治疗(辅助：47例；新辅助：11例),4.6%（24/519）接受了免疫治疗(辅助：22例；新辅助：2例)。3年生存率为77.4%，中位总生存期（mOS）为7.5年（95%可信区间[CI]: 6.7 ne），辅助治疗的mOS最高（7.5年[95% CI: 7.0 ne]年）。结论：这项现实世界的研究显示，根据指南建议，辅助治疗的使用率为50%，但新辅助治疗的使用率较低。诊断时的生物标志物检测较低，反映了在靶向和免疫治疗之前的研究时期。随着最近新（neo）佐剂的批准，需要多学科的方法来做出更好的治疗决策，以改善早期NSCLC的预后。

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

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.