Stage III non-small-cell lung cancer (NSCLC) represents a heterogeneous population ranging from apparently resectable tumors to inoperable disease. Patients diagnosed with stage III NSCLC can be treated with surgery, chemoradiotherapy, radiotherapy, and chemotherapy, depending on clinical decision by disease condition such as tumor volume, presence and number of lymph node metastasis, and patient’s background. This study aims to clarify the treatment reality in Japanese patients with stage III NSCLC.
A retrospective observational study was conducted in 11 institutions in Japan, and patients diagnosed as clinical stage III NSCLC during January 2013 to December 2014 were included. We evaluated the patient characteristics, details of treatments, and efficacy and safety outcomes per each treatment choice.
In total, 790 patients were enrolled in this study, of whom 744 patients were full analysis set (FAS). Patient characteristics at diagnosis were as follows: Median age was 68 years old. Number of resectable and unresectable at diagnosis were 186 (25%) and 558 (75%), respectively. Number of stage IIIA and IIIB were 438 (59%) and 306 (41%). Number of patients per treatment modality was as follows: surgery (including both with and without perioperative treatment), 149 (20%); chemoradiotherapy, 343 (46%); chemotherapy alone, 165 (22%); and radiotherapy alone, 87 (12%). The proportion of stage IIIA was 96% in the surgical group and 39%-61% in the other groups. The median overall survival (mOS) of FAS was 25 months, and the 5-year survival rate was 28%. The mOS of surgery, chemoradiotherapy, chemotherapy, and radiotherapy were 43, 30, 17, and 14 months, and the 5-year survival rates were 44%, 33%, 14%, and 6%, respectively. The incidence of pneumonitis and radiation-pneumonitis in patients treated with chemoradiotherapy was 37% and in radiotherapy was 16%.
To our knowledge, this is the first study reporting the treatment reality in patients diagnosed with stage III NSCLC in Japan. Our study revealed the proportion of initial treatment in the real-world practice accompanied with the patient characteristics, prognosis, and safety focusing on radiation-related adverse events.
UMIN000031385.
AstraZeneca K.K.
AstraZeneca K.K.
H. Murakami: Honoraria (self), Research grant/Funding (institution): AstraZeneca; Honoraria (self), Research grant/Funding (institution): Chugai; Honoraria (self), Research grant/Funding (institution): Eli Lilly; Honoraria (self), Research grant/Funding (institution): Taiho; Honoraria (self), Research grant/Funding (institution): Takeda; Honoraria (self): Ono; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): MSD; Research grant/Funding (institution): AbbVie; Research grant/Funding (institution): Daiichi Sankyo; Research grant/Funding (institution): IQVIA. H. Harada: Honoraria (self): AstraZeneca; Honoraria (self): Brainlab; Honoraria (self): Taiho; Honoraria (self): Nippon Chemiphar ; Honoraria (self): Merck Biopharma; Honoraria (self): Chugai; Honoraria (self): Novartis. S. Atagi: Honoraria (self), Research grant/Funding (institution): AstraZeneca; Honoraria (self), Research grant/Funding (institution): MSD; Honoraria (self), Research grant/Funding (institution): Eli Lilly; Honoraria (self), Research grant/Funding (institution): Chugai; Honoraria (self), Research grant/Funding (institution): Ono; Honoraria (self), Research grant/Funding (institution): Taiho; Honoraria (self), Research grant/Funding (institution): Boehringer Ingelheim; Honoraria (self), Research grant/Funding (institution): Pfizer; Honoraria (self), Research grant/Funding (institution): Bristol-Myers Squibb; Honoraria (self): Hisamitsu; Honoraria (self): Kyowa Kirin; Research grant/Funding (institution): F. Hoffmann-La Roche. T. Tokito: Honoraria (self): AstraZeneca; Honoraria (self): Chugai; Honoraria (self): Boehringer Ingelheim. S. Oizumi: Honoraria (self), Research grant/Funding (institution): AstraZeneca. T. Kozuki: Honoraria (self), Research grant/Funding (institution): AstraZeneca; Honoraria (self), Research grant/Funding (institution): Chugai; Honoraria (self), Research grant/Funding (institution): Eli Lilly; Honoraria (self): Ono; Honoraria (self), Research grant/Funding (institution): Bristol-Myers Squibb; Honoraria (self), Research grant/Funding (institution): Taiho; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Nippon Kayaku; Honoraria (self): MSD; Honoraria (self): Novartis; Honoraria (self): Kyowa Kirin; Honoraria (self): Pfizer; Research grant/Funding (institution): Merck Biopharma. M. Seike: Honoraria (self): AstraZeneka; Honoraria (self), Research grant/Funding (institution): MSD; Honoraria (self), Research grant/Funding (institution): Chugai; Honoraria (self), Research grant/Funding (institution): Taiho; Research grant/Funding (institution): Eli Lilly; Research grant/Funding (institution): Boehringer Ingelheim. M. Jinushi: Full/Part-time employment: AstraZeneca. H. Horinouchi: Honoraria (self), Research grant/Funding (institution): Bristol-Myers Squibb; Honoraria (self), Research grant/Funding (institution): MSD; Honoraria (self), Research grant/Funding (institution): Chugai; Honoraria (self), Research grant/Funding (institution): Taiho; Honoraria (self), Research grant/Funding (institution): AstraZeneca; Research grant/Funding (institution): Astellas; Research grant/Funding (institution): Merck Serono; Research grant/Funding (institution): Genomic Health; Research grant/Funding (institution): Eli Lilly; Research grant/Funding (institution): Ono. All other authors have declared no conflicts of interest.