Survival analysis of advanced lung cancer patients undergoing personalised treatment or chemotherapy in a real clinic

Abstract

IntroductionThe importance of modern treatments for the extension of overall survival in advanced lung cancer (LC) patients is rarely reported in clinical trials (crossover effect). Recent clinical trials have compared experimental treatment methods and shown that chemotherapy is no longer a comparator. We studied the relevance of innovative treatment to the extension of overall survival in Polish lung cancer patients.Material and methodsWe described the outcome in 1463 patients diagnosed and treated for advanced LC. The study included patients receiving all available forms of treatment, i.e. chemotherapy, immunotherapy, EGFR tyrosine kinase inhibitors, ALK inhibitors, and best supportive care (BSC).ResultsMedian OS (mOS) for the whole group of patients was 6.5 months. mOS was significantly higher in patients with SCC (8.0 months) and AC (7.0 months) compared to patients with SCLC (6 months) and NSCLC NOS (3.5 months). mOS was 30 months for EGFR TKI-treated patients, 34 months for patients receiving second-line immunotherapy, 8.5 months for chemotherapy patients, and 1.0 month for patients who received BSC. mOS for patients treated with ALK inhibitors and first-line immunotherapy was not reached. The use of targeted therapies or immunotherapies significantly (p < 0.0001) reduced the risk of death compared to chemotherapy (HR = 0.373, 95% CI: 0.288–0.484 and HR = 0.313, 95% CI: 0.255–0.385).ConclusionsThe use of modern therapies in one of the treatment lines compared to chemotherapy significantly increased the long-term survival of advanced LC patients (34.5 vs. 8.5 months, HR = 0.336, 95% CI: 0.284– 0.397, p < 0.0001). Correct and early LC diagnosis is required, because patients with late diagnosis have a particularly poor prognosis.