TY - JOUR
T1 - Deciphering the clinical features of heterogeneous stage III non-small cell lung cancer in Japanese real-world clinical practice
T2 - Expanded cohort of the SOLUTION study
AU - Murakami, Haruyasu
AU - Horinouchi, Hidehito
AU - Harada, Hideyuki
AU - Sobue, Tomotaka
AU - Kato, Tomohiro
AU - Atagi, Shinji
AU - Kozuki, Toshiyuki
AU - Tokito, Takaaki
AU - Oizumi, Satoshi
AU - Seike, Masahiro
AU - Ohashi, Kadoaki
AU - Mio, Tadashi
AU - Sone, Takashi
AU - Jinushi, Masahisa
AU - Tsuboi, Masahiro
N1 - Funding Information:
The authors thank all the clinicians who participated in this study. The authors also thank Nicholas D. Smith (EMC K.K.) for medical writing support, which was funded by AstraZeneca K.K. AstraZeneca K.K. funded the study, medical writing support, and publication fees.
Publisher Copyright:
© 2021 The Authors
PY - 2022/3
Y1 - 2022/3
N2 - Objectives: To evaluate the actual treatment patterns with respective outcomes and the patient characteristics of stage III non-small cell lung cancer (NSCLC) in Japan. Materials and methods: Patients (aged ≥20 years at diagnosis) who were diagnosed with stage III NSCLC between January 2013 and December 2014 and underwent surgery, chemoradiotherapy (CRT), chemotherapy (CT), or radiotherapy (RT) at 11 institutions in Japan were consecutively registered in this retrospective, observational study (SOLUTION; UMIN000031385). Study measures included patient characteristics, first-line treatments, overall survival (OS), progression-free survival, objective response rate, and incidence of radiation-related adverse events. Results: The study population comprised 744 patients. The tumors were classified as stage IIIA and IIIB in 58.9% and 41.1% of patients, respectively. The tumors were considered resectable at diagnosis in 25.0% of patients. First-line treatments were surgery (20.0%), CRT (46.1%), CT (22.2%), and RT (11.7%). The median OS (mOS) in the overall population was 25.4 months and the 3-year OS rate was 38.7%. Among the four first-line treatment cohorts, OS most favored the surgery cohort: mOS was 43.4 months and the 3-year OS rate was 53.8%. Prognostic factors for OS in each treatment modality were analyzed using multivariable analysis and included the following: age, performance status, and histological type for the surgery cohort; sex, histological type, and primary lesion location (lower lobe) for the CRT cohort; and performance status and clinical stage for the RT cohort. The timing of peak incidence of pneumonitis from the start of first-line treatment was 18–20 and 12–14 weeks in the CRT and RT cohorts, respectively. Conclusion: Patients with clinical stage III NSCLC received a variety of treatments selected to the clinical background and tumor status, and we clarified the outcome and prognostic factors. These findings will be a useful reference for future studies evaluating newly introduced treatments for stage III NSCLC.
AB - Objectives: To evaluate the actual treatment patterns with respective outcomes and the patient characteristics of stage III non-small cell lung cancer (NSCLC) in Japan. Materials and methods: Patients (aged ≥20 years at diagnosis) who were diagnosed with stage III NSCLC between January 2013 and December 2014 and underwent surgery, chemoradiotherapy (CRT), chemotherapy (CT), or radiotherapy (RT) at 11 institutions in Japan were consecutively registered in this retrospective, observational study (SOLUTION; UMIN000031385). Study measures included patient characteristics, first-line treatments, overall survival (OS), progression-free survival, objective response rate, and incidence of radiation-related adverse events. Results: The study population comprised 744 patients. The tumors were classified as stage IIIA and IIIB in 58.9% and 41.1% of patients, respectively. The tumors were considered resectable at diagnosis in 25.0% of patients. First-line treatments were surgery (20.0%), CRT (46.1%), CT (22.2%), and RT (11.7%). The median OS (mOS) in the overall population was 25.4 months and the 3-year OS rate was 38.7%. Among the four first-line treatment cohorts, OS most favored the surgery cohort: mOS was 43.4 months and the 3-year OS rate was 53.8%. Prognostic factors for OS in each treatment modality were analyzed using multivariable analysis and included the following: age, performance status, and histological type for the surgery cohort; sex, histological type, and primary lesion location (lower lobe) for the CRT cohort; and performance status and clinical stage for the RT cohort. The timing of peak incidence of pneumonitis from the start of first-line treatment was 18–20 and 12–14 weeks in the CRT and RT cohorts, respectively. Conclusion: Patients with clinical stage III NSCLC received a variety of treatments selected to the clinical background and tumor status, and we clarified the outcome and prognostic factors. These findings will be a useful reference for future studies evaluating newly introduced treatments for stage III NSCLC.
KW - Chemoradiotherapy
KW - Chemotherapy
KW - Pneumonitis
KW - Radiotherapy
KW - Real-world
KW - Stage III non-small cell lung cancer
KW - Surgery
KW - Survival
KW - Treatment
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UR - http://www.scopus.com/inward/citedby.url?scp=85124105680&partnerID=8YFLogxK
U2 - 10.1016/j.lungcan.2021.12.005
DO - 10.1016/j.lungcan.2021.12.005
M3 - Article
AN - SCOPUS:85124105680
VL - 165
SP - 152
EP - 163
JO - Lung Cancer
JF - Lung Cancer
SN - 0169-5002
ER -
