First-Line Pharmacotherapies and Survival among Patients Diagnosed with Non-Resectable NSCLC: A Real-Life Setting Study with Gender Prospective

Abstract

(1) Purpose: To describe first-line pharmacotherapy and overall survival in non-resectable non-small cell lung cancer (nrNSCLC) patients by gender. (2) Methods: Incident cases of nrNSCLC recorded between 2009 and 2019 (cohort entry) in the pathology registry of the regional administrative healthcare database of Tuscany were identified. Records of antineoplastic therapies delivered up to 4 months following cohort entry were classified as chemotherapy, target therapies, immunotherapies, and undefined monoclonal antibodies. First-line treatment and survival of patients receiving drug treatment was described. Analyses were stratified according to histology, gender, and cohort entry year. (3) Results: 4393 incident cases of nrNSCLC were included. Women with non-squamous-NSCLC received target-therapy more frequently than men (14.9% vs. 6.5%). Immunotherapy incidence of use varied between 3.8% (2017) and 9.1% (2019). The 2-year survival rate increased over time: for non-squamous-NSCLC, it was 22.3% (2009–2011) and 30.6% (2018–2019), while for squamous-NSCLC, it was 13.5% and 22.5%, respectively. After multivariate analysis, a low reduction in mortality risk in 2018–2019 vs. 2009–2011 was found (non-squamous: HR: 0.95 CI95%: 0.92–0.98; squamous: HR: 0.94 CI95%: 0.90–0.98). Among non-squamous NSCLC, median survival was longer in women than in men (389 vs. 276 days). (4) Conclusion: In light of sex-related biomolecular differences, among non-squamous NSCLC, women received target-therapy more frequently than men. Survival seemed to slightly improve over the study period for both histologies, despite a poor reduction in mortality risk was still observed.

Safety of Anti-Angiogenic Drugs in Pediatric Patients with Solid Tumors: A Systematic Review and Meta-Analysis

“…Additionally, gender may affect the metabolic activity of enzymes involved in pharmacokinetics of pro-angiogenic drugs. Nevertheless, despite gender seemingly playing a role in the survival of patients exposed to anticancer drugs [ 111 , 112 ], the role of sex and gender on safety for anticancer drug use, in particular, for anti-angiogenic drugs, is still controversial (especially in the pediatric population). Notably, none of the study included in this review discussed the tolerability results of anti-angiogenic drugs with respect to sex and gender.…”

NSCLC as the Paradigm of Precision Medicine at Its Finest: The Rise of New Druggable Molecular Targets for Advanced Disease

“…These observations seem to suggest that a reduction in incidence coupled with treatment advances, in particular the rise of targeted therapies, is likely responsible for the reduced mortality in NSCLC subgroup. Despite strong evidence, this topic is still a matter of debate [ 125 , 126 ] and further confirmatory studies evaluating the effect of novel targeted therapies, subtype-specific mortality trends and screening, are needed.…”

Development and validation of a case-finding algorithm for the identification of non-small cell lung cancers in a region-wide Italian pathology registry

“…Given the promising evidence on validity reported in this work, the final version of the NSCLC-finding algorithm designed and tested in this study can be considered suitable for epidemiology and pharmacoepidemiology studies. In fact, the proposed case-finding algorithm was recently used to identify a cohort of NSCLC patients in a recently published pharmacoepidemiological study [ 15 ]. Notably, the characteristics of the study cohort were in line with those expected from the disease epidemiology [ 1 , 2 ].…”