Impact of Targeted Therapy on the Survival of Patients With Advanced-Stage Non-small Cell Lung Cancer in Oncosalud - AUNA

Abstract

Background Lung cancer is still a prevalent and fatal neoplasm in developing countries. In the last decades, chemotherapy (CHT) maintenance occupied an important role in the treatment, as well as targeted therapies. We aimed to evaluate the survival impact of targeted therapy in advanced lung cancer at a private Peruvian institution (Oncosalud - AUNA). Methods We reviewed retrospectively medical records of patients with advanced-stage non-small cell lung cancer (NSCLS) (clinical stage III-IV) who received CHT and maintenance treatment with target therapy (TT) or CHT. The impact was assessed by progression-free survival (PFS) and overall survival (OS) using the Kaplan–Meier method, and comparisons of survival curves were performed using log-rank or Breslow test and Cox model. Results The median age of the patients was 65 years. Clinical characteristics, as well as the treatment type, showed no significant difference between the two groups. The maintenance schedule in those receiving CHT was generally pemetrexed (70%) and in those receiving TT was erlotinib (60.7%). In patients receiving TT, the median PFS was 13 months compared to 7 months in those receiving CHT; likewise, the median OS was 45 and 17 months, respectively. The PFS and OS curves showed significant differences ( P < .05), achieving a better survival in subjects treated with TT. Conclusion Progression-Free Survival and OS were superior in patients who received targeted therapy than those treated only with CHT, the 2 years rate of PFS and OS was nearly double to those who received only CHT-based treatments.

Tiempo al acceso al tratamiento dirigido en cáncer de pulmón de células no pequeñas no escamoso metastásico

“…Sin embargo, tanto en nuestro país como en América, el acceso al testeo molecular y posteriormente al tratamiento dirigido, no está ampliamente disponible, ni existe un registro exacto, sino más bien reportes de distintos establecimientos e instituciones, ya sea de forma individual o mediante colaboraciones [7][8][9][10] .…”

Impact of Molecular Biomarker Test Availability and Timing on Metastatic Non-Small-Cell Lung Cancer Treatment Selection and Clinical Outcomes in the U.S. Medicare Population

“…Notwithstanding these possible explanations, the lower-than-expected utilization of targeted therapies is a potential concern given their established role-further strengthened by the results of this study-in improving outcomes and, importantly, patient survival. Evidence has accumulated over the past several years that, when compared with chemotherapy only in particular, the use of biomarker-informed targeted therapy has extended survival in statistically signi cant and clinically meaningful amounts [30][31][32][33][34].…”

Current treatments for non-small cell lung cancer

“…Hence, there is an urgency to develop more nonspecific therapies so they can be used to treat more lung cancer patients. The high cost of targeted therapy in the clinical treatment of lung cancer still limits its usage ( 143 ). Additionally, there are also some questions such as chemo-resistance in clinical therapy with the wide use of targeted drugs.…”