Abstract

Non-small cell lung cancer (NSCLC) is often diagnosed at an advanced stage. Clinical trials have demonstrated that first-line immunotherapy alone or in combination with chemotherapy improves overall survival. However, reports of survival outcomes in real-world settings are limited. We assessed survival in advanced NSCLC patients treated with immunotherapy alone or in combination with chemotherapy in first- or second-line at the Windsor Regional Cancer Program (WRCP) and compared it to existing literature. We included patients diagnosed with stage IV NSCLC from January 2015 to December 2020 and treated with first-line chemoimmunotherapy (ChemoImmuno1), chemotherapy followed by immunotherapy (Chemo1), or immunotherapy followed by chemotherapy (Immno1) in our survival analysis. Patients with oncogene-addicted mutations were excluded. There were 160 patients of which 41.5% were female. Mean age was 68 years. Median overall survival from time of diagnosis was 474 days (95% CI: 249, 949) with an estimated 5-year survival of 11.1% (95% CI: 4.5, 21.3). Median OS in ChemoImmuno1 was 9.6 months, in Chemo1 was 19.2 months from time of diagnosis and 10.5 months from time of initiation of immunotherapy, and in Immuno1 was 18.4 months, respectively. Estimated survival at three years from time of diagnosis for ChemoImmuno1 was 17.6% and for Immuno1 was 17.9%. For Chemo1, from diagnosis it was 20.1% and from second-line therapy it was 15.4%. Survival outcomes were comparable to clinical trials and other studies. Real-world survival outcomes of immunotherapy for advanced NSCLC are comparable to the existing literature in this single center study.

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