Epidemiological, clinical profile, and treatment outcome of stage iv nonsquamous nonsmall cell lung cancer patients presenting to tertiary care hospital in North India

Background: Better planning of limited resources in oncology is possible with more real-world data of lung cancer, one of the most common causes of cancer related mortality in India and Globe. Aim: This study aimed to evaluate the clinical profile and treatment outcomes in patients with Stage IV adenocarcinoma of lung at our center. Materials and Methods: One hundred and eighty-two patients with Stage IV adenocarcinoma of lung were prospectively screened and analyzed, of which 107 patients who met the inclusion criteria were included in the final analysis. Patients with epidermal growth factor receptor (EGFR) and echinodermal microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) genomic alterations were treated with tyrosine kinase inhibitors and others were treated as per standard chemotherapy regimens. Response rates (RRs), progression-free survival (PFS), and overall survival (OS) were measured. Results: Median age of patients was 55.6 years (range, 26–82) with a male-to-female ratio of 1.23:1. Analyses for EGFR and EML4-ALK alterations were possible for 104 (96.3%) patients and were detected in 31.7% and 8.7% patients, respectively. The overall RR for the entire cohort was 51.4%, while median PFS and median OS were 6.9 and 13.7 months, respectively. Median PFS for the EGFR-mutated and ALK-rearranged group was 9.6 and 10.2 months, respectively, which was higher than non-EGFR non-ALK patients. Median OS for the whole cohort was 13.7 months, while median OS was not reached for EGFR and ALK altered groups. Conclusions: As patients with driver mutations like EGFR and ALK have better prognosis than those who do not, every patient diagnosed with advanced nonsmall cell lung cancer should be offered mutational analysis.