Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States
Abstract Introduction Characteristics of patients in clinical trials may differ from those of real‐world patients. Our objective was to describe biomarker testing and outcomes among patients with advanced non‐small cell lung cancer (aNSCLC) in a real‐world setting. Methods This retrospective cohort...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6694 |
| _version_ | 1827395173322063872 |
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| author | Mo Yang Joanna P. MacEwan Sai Sriteja Boppudi Monica R. McClain Richard M. O'Hara Jr Paul K. Paik |
| author_facet | Mo Yang Joanna P. MacEwan Sai Sriteja Boppudi Monica R. McClain Richard M. O'Hara Jr Paul K. Paik |
| author_sort | Mo Yang |
| collection | DOAJ |
| description | Abstract Introduction Characteristics of patients in clinical trials may differ from those of real‐world patients. Our objective was to describe biomarker testing and outcomes among patients with advanced non‐small cell lung cancer (aNSCLC) in a real‐world setting. Methods This retrospective cohort study included patients ≥18 years old, diagnosed with stage IIIB/C or IV NSCLC, and in the TEMPUS oncology dataset from January 1, 2012, to December 31, 2020. Patient characteristics associated with biomarker testing were evaluated in patients with positive biomarkers using univariate logistic regression models. Cox proportional hazard models were used to estimate median survival. Results Of 9540 patients included, 41.7% had biomarker testing, and 2158 had a positive biomarker result. Men (vs women; odds ratio [OR], 0.82; 95% CI: 0.74–0.91), Black patients (vs White; OR, 0.83; 95% CI: 0.72–0.97), patients with squamous (OR, 0.22; 95% CI: 0.19–0.25) or unknown histology (OR, 0.53; 95% CI: 0.45–0.61) (vs non‐squamous histology), and patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 2+ (OR, 0.69; 95% CI: 0.57–0.84) or missing (OR, 0.56; 95% CI: 0.48–0.66) (vs ECOG PS of 0) were less likely to undergo biomarker testing. Patients with positive biomarkers who received NCCN‐recommended treatment options (55.7%) had significantly longer median overall survival (OS) (hazard ratio [HR], 0.84; 95% CI: 0.75–0.95) and real‐world progression‐free survival (rwPFS) (HR, 0.68; 95% CI: 0.62–0.75). Conclusion More than 50% of patients were untested for biomarkers. Patients who were less likely to be tested included men, Black patients, current smokers, patients with squamous aNSCLC, and patients with an ECOG PS of 2+. Patients with positive biomarkers who received NCCN‐recommended treatment options had significantly longer OS and PFS. |
| first_indexed | 2024-03-08T18:28:05Z |
| format | Article |
| id | doaj.art-cae17f97ca924a338f77e6f7e6945e2f |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T18:28:05Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-cae17f97ca924a338f77e6f7e6945e2f2023-12-30T08:53:25ZengWileyCancer Medicine2045-76342023-12-011224216052161410.1002/cam4.6694Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United StatesMo Yang0Joanna P. MacEwan1Sai Sriteja Boppudi2Monica R. McClain3Richard M. O'Hara Jr4Paul K. Paik5EMD Serono Rockland Massachusetts USAGenesis Research Hoboken New Jersey USAGenesis Research Hoboken New Jersey USAGenesis Research Hoboken New Jersey USAEMD Serono Rockland Massachusetts USAMemorial Sloan Kettering Cancer Center New York New York USAAbstract Introduction Characteristics of patients in clinical trials may differ from those of real‐world patients. Our objective was to describe biomarker testing and outcomes among patients with advanced non‐small cell lung cancer (aNSCLC) in a real‐world setting. Methods This retrospective cohort study included patients ≥18 years old, diagnosed with stage IIIB/C or IV NSCLC, and in the TEMPUS oncology dataset from January 1, 2012, to December 31, 2020. Patient characteristics associated with biomarker testing were evaluated in patients with positive biomarkers using univariate logistic regression models. Cox proportional hazard models were used to estimate median survival. Results Of 9540 patients included, 41.7% had biomarker testing, and 2158 had a positive biomarker result. Men (vs women; odds ratio [OR], 0.82; 95% CI: 0.74–0.91), Black patients (vs White; OR, 0.83; 95% CI: 0.72–0.97), patients with squamous (OR, 0.22; 95% CI: 0.19–0.25) or unknown histology (OR, 0.53; 95% CI: 0.45–0.61) (vs non‐squamous histology), and patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 2+ (OR, 0.69; 95% CI: 0.57–0.84) or missing (OR, 0.56; 95% CI: 0.48–0.66) (vs ECOG PS of 0) were less likely to undergo biomarker testing. Patients with positive biomarkers who received NCCN‐recommended treatment options (55.7%) had significantly longer median overall survival (OS) (hazard ratio [HR], 0.84; 95% CI: 0.75–0.95) and real‐world progression‐free survival (rwPFS) (HR, 0.68; 95% CI: 0.62–0.75). Conclusion More than 50% of patients were untested for biomarkers. Patients who were less likely to be tested included men, Black patients, current smokers, patients with squamous aNSCLC, and patients with an ECOG PS of 2+. Patients with positive biomarkers who received NCCN‐recommended treatment options had significantly longer OS and PFS.https://doi.org/10.1002/cam4.6694advanced NSCLCbiomarker testingoutcomesreal‐world datatargeted therapy |
| spellingShingle | Mo Yang Joanna P. MacEwan Sai Sriteja Boppudi Monica R. McClain Richard M. O'Hara Jr Paul K. Paik Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States Cancer Medicine advanced NSCLC biomarker testing outcomes real‐world data targeted therapy |
| title | Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States |
| title_full | Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States |
| title_fullStr | Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States |
| title_full_unstemmed | Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States |
| title_short | Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States |
| title_sort | diagnosis testing treatment and outcomes among patients with advanced non small cell lung cancer in the united states |
| topic | advanced NSCLC biomarker testing outcomes real‐world data targeted therapy |
| url | https://doi.org/10.1002/cam4.6694 |
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