Abstract
Simple SummaryWomen and men have a different biomolecular profile that could impact drug utilization and survival in non-small cell lung cancer (NSCLC) patients. The aim of the study was to describe first-line pharmacotherapy and overall survival in non-resectable (nr)NSCLC patients by gender. About 4400 incident cases of nrNSCLC were included. We reported a different use of target therapies on the basis of the known biomolecular profile between the two sexes. The survival improved in the last decade, and women and men also showed different survival if diagnosed with a squamous or non-squamous nrNSCLC.(1) Purpose: To describe first-line pharmacotherapy and overall survival in non-resectable non-small cell lung cancer (nrNSCLC) patients by gender. (2) Methods: Incident cases of nrNSCLC recorded between 2009 and 2019 (cohort entry) in the pathology registry of the regional administrative healthcare database of Tuscany were identified. Records of antineoplastic therapies delivered up to 4 months following cohort entry were classified as chemotherapy, target therapies, immunotherapies, and undefined monoclonal antibodies. First-line treatment and survival of patients receiving drug treatment was described. Analyses were stratified according to histology, gender, and cohort entry year. (3) Results: 4393 incident cases of nrNSCLC were included. Women with non-squamous-NSCLC received target-therapy more frequently than men (14.9% vs. 6.5%). Immunotherapy incidence of use varied between 3.8% (2017) and 9.1% (2019). The 2-year survival rate increased over time: for non-squamous-NSCLC, it was 22.3% (2009–2011) and 30.6% (2018–2019), while for squamous-NSCLC, it was 13.5% and 22.5%, respectively. After multivariate analysis, a low reduction in mortality risk in 2018–2019 vs. 2009–2011 was found (non-squamous: HR: 0.95 CI95%: 0.92–0.98; squamous: HR: 0.94 CI95%: 0.90–0.98). Among non-squamous NSCLC, median survival was longer in women than in men (389 vs. 276 days). (4) Conclusion: In light of sex-related biomolecular differences, among non-squamous NSCLC, women received target-therapy more frequently than men. Survival seemed to slightly improve over the study period for both histologies, despite a poor reduction in mortality risk was still observed.
Highlights
Lung cancer is the most commonly diagnosed cancer in the world
Data from three different registries were used to retrieve information on drug treatments: (1) the Outpatient Drug Dispensings (ODD) registry, which records the specific medicinal product used during outpatient encounters or dispensed for outof-hospital use; (2) the registries of Hospital Discharge Records (HDR); and (3) the Outpatient Encounter and diagnostic procedures Data (OED), in which infusive antineoplastic administration procedures executed during hospitalization and outpatients encounters, respectively, are recorded as either unspecified standard chemotherapy or monoclonal antibody therapy
A total of 4393 incident patients with unresectable primary non-small cell lung cancer (NSCLC) were included in the analysis and followed until June 2020
Summary
Lung cancer is the most commonly diagnosed cancer in the world. It represents 14.5%of total cancer cases in men and 8.4% in women, being the leading cause of cancer death in men (22.0%). Lung cancer is the most commonly diagnosed cancer in the world. Of total cancer cases in men and 8.4% in women, being the leading cause of cancer death in men (22.0%). The World Health Organization divides lung cancer into two classes: small cell lung cancer and non-small cell lung cancer (NSCLC). The latter represents 85% of all cases of lung cancer, and its diagnosis is usually based on diagnostic imaging (chest X-ray and computed tomography) and the anatomopathological evaluation of a biological sample [2]. The latter subtype is proportionally much more frequent in women than in men [3]
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