Real-world treatment patterns and outcomes for patients with non-metastatic non-small cell lung cancer: retrospective analyses in Canada, England, and Germany

Abstract Background Recent therapeutic advancements for non-metastatic non-small cell lung cancer (NSCLC) have increased the need for real-world baselines against which future changes in patient management and clinical outcomes can be compared. Methods Data on patient characteristics, initial treatm...

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Main Authors: Alastair Greystoke, Melinda J. Daumont, Caroline Rault, Hannah Baltus, Philip Q. Ding, Gabrielle Emanuel, Stefano Lucherini, Lien Vo, Valeria M. Saglimbene, Eleanor Ralphs, Cátia Leal, Minouk J. Schoemaker, Alexander Katalinic, Annika Waldmann, Winson Y. Cheung
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03715-9
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Summary:Abstract Background Recent therapeutic advancements for non-metastatic non-small cell lung cancer (NSCLC) have increased the need for real-world baselines against which future changes in patient management and clinical outcomes can be compared. Methods Data on patient characteristics, initial treatment, and overall survival (OS) were derived from adult patients diagnosed with stage I-IIIC NSCLC (2010–2020) in a regional Canadian database (Oncology Outcomes [O2]), an English national registry (Cancer Analysis System [CAS]), and four regional German registries (VONKOdb) and retrospectively analyzed separately using analogous methodology. Results Data from 85,433 patients were analyzed. Stage at diagnosis varied, with proportions with stage I NSCLC ranging from 30.9% (VONKOdb) to 44.2% (O2) and with stage III disease from 36.9% (O2) to 48.5% (VONKOdb). Across the data sources, proportions receiving surgery ± other treatments were similar for stages I and II, but decreased through stages IIIA, IIIB, and IIIC (range, 24.7–42.7%, 4.6–21.8%, and 0.9–7.5%, respectively). Overall, 70.3–85.2% of patients received active treatment for NSCLC, with a trend toward lower proportions among those with stage III disease. Reached median OS tended to be longest in patients with resected stage I/II NSCLC (range, 28.8–128.0 months) and shortest in patients with stage IIIB/IIIC disease treated with systemic anticancer therapy (SACT) alone, radiotherapy alone, or SACT + palliative radiotherapy (range, 4.8–21.2 months). Conclusions These data provide insights into treatment pathways and survival outcomes before the widespread use of immunotherapy-based and targeted therapies and will serve as an important baseline for future evaluations of emerging treatments for patients with non-metastatic NSCLC.
ISSN:1471-2466