Real-World Characteristics, Biomarker Testing, & Adjuvant Therapy for Resected NSCLC

Photo Credit: NiseriN

At the 2023 North American Conference on Lung Cancer, held December 1-3 in Chicago, Xiaohan Hu, presented as part of an oral abstract session, a recap on “Real-World Patients Characteristics, Biomarker Testing, and Adjuvant Therapy for Resected NSCLC at U.S. Oncology Clinics, 2019-2023”

Hu recently published two papers that address this topic, which we summarize here:

Evaluation of Disease-Free Survival as a Predictor of Overall Survival and Assessment of Real-World Burden of Disease Recurrence in Resected Early-Stage non-Small Cell Lung Cancer

J Manag Care Spec Pharm. 2023 Jul;29(7):749-757.
Summary: In early-stage non-small cell lung cancer (NSCLC) clinical trials, intermediate endpoints like disease-free survival (DFS) have demonstrated a strong correlation with overall survival (OS). However, limited real-world data exist, and previous studies haven’t quantified the clinical and economic impact of disease recurrence.

This study aims to explore the association between real-world DFS (rwDFS) and OS and quantify the link between NSCLC recurrence and health care resource utilization (HCRU), health care costs, and OS in U.S. patients with resected early-stage NSCLC.

A retrospective observational analysis of data from the Surveillance, Epidemiology, and End Results-Medicare database (2007-2019) included patients with newly diagnosed stage IB to IIIA NSCLC who underwent surgery. Patient characteristics were described, and rwDFS and OS were compared between those with and without recurrence. Correlation was assessed, and the impact of recurrence on HCRU, costs, and OS was analyzed.

Of 1,761 surgical patients, 1,182 (67.1%) experienced recurrence, correlating with shorter OS and rwDFS. Recurrence was associated with higher HCRU, health care costs, and increased risk of death.

Postsurgery rwDFS significantly correlates with OS in early-stage NSCLC, emphasizing the need to prevent or delay recurrence to reduce the substantial clinical and economic burdens on patients and the healthcare system.

Clinical and Economic Impact of Recurrence in Early-Stage Non-Small-Cell Lung Cancer Following Complete Resection

Future Oncol. 2023 Jun;19(20):1415-1427.
Summary: To gain insights into the outcomes of early-stage non-small-cell lung cancer (NSCLC) and assess the advantages of emerging therapies, real-world data are essential, this retrospective analysis, utilizing the ConcertAI Patient360™ database, compared overall survival and healthcare resource utilization between patients with recurrent and non-recurrent completely resected stage IB-IIIA NSCLC. Recurrence was linked to a significantly shorter median overall survival (31.5 months vs. 75.6 months for non-recurrent cases), a lower 5-year survival probability post-resection, and increased healthcare resource utilization. Patients experiencing late recurrence exhibited a longer restricted mean survival time compared to those with early recurrence. Findings from this real-world investigation underscore the potential significance of averting or delaying recurrence in individuals with early-stage NSCLC.