Describing initial treatment (tx) post-NSCLC diagnosis is important in order to understand clinicians’ intent in routine care, based on pt/disease characteristics and disease stage at diagnosis. The SCAN-LEAF project aims to describe the epidemiology, clinical care and outcomes of NSCLC pts in Scandinavia. Here, we report initial tx and outcomes among pts with incident NSCLC in Denmark from 2005-2015.
The Danish cohort, established by linkage of Danish national registries, includes all adult pts with incident NSCLC from 2005-2015 (follow-up until Dec 2016). Initial tx includes lung surgery, radiotherapy (RT) and systemic anticancer therapy (SACT) captured through procedure codes (no drug names); it is defined as the first tx received at any time after diagnosis associated with any other tx received within 12 wks of this first tx start. Further analyses will assess the changes in initial tx patterns and overall survival over time, using the Kaplan–Meier method.
Of the 31,939 pts with incident NSCLC, mean age was 68.4 yrs (13.3% ≥80 yrs) and 48.0% were women. TNM stage distribution (stage I, II, IIIA, IIIB, IV, missing) was 12.9%, 7.3%, 11.2%, 11.7%, 51.6% and 5.2%, respectively. 54.4% had non-squamous cell carcinoma and 26.5% squamous cell carcinoma. Initial tx is shown in the table. The proportion of pts receiving SACT (alone or with surgery/RT) was 12.1%, 42.4%, 61.0%, 64.3% and 55.4% in stages I–IV, respectively. The proportion of untreated pts increased from 6.9% in stage I to 24.1% in stage IV.
From 2005-2015, half of NSCLC pts were diagnosed at stage IV. Most pts at stage I and II were treated with surgery, adjuvant/neoadjuvant SACT being relatively uncommon. At stage III, most pts received SACT either as adjuvant/neoadjuvant tx (1/5 of stage IIIA), associated with RT (1/4 of stage IIIA/B) or alone (1/5 of stage IIIA; 1/3 of stage IIIB). Only half of metastatic pts received SACT, highlighting a significant unmet treatment need in NSCLC.
Clinical trial identification
Legal entity responsible for the study
S. Ekman: Grants: Bristol-Myers Squibb, during the conduct of the study. P. Horvat, D. Layton, J. Kim, M. Rosenlund: Employee: IQVIA. A. Juarez-Garcia: Employee: Bristol-Myers Squibb. H.C. Jacobs: Personal fees: Bristol-Myers Squibb, during the conduct of the study. L. Lacoin: Consultant epidemiologist contracted: Bristol-Myers Squibb for the SCAN-LEAF project. All other authors have declared no conflicts of interest.Table: 1483P
|Stage I (N = 4138)||Stage II (N = 2322)||Stage IIIA (N = 3594)||Stage IIIB (N = 3735)||Stage IV (N = 16,486)|
|Initial treatment, %|
|Surgery with neoadjuvant or adjuvant SACT||7.8||29.4||18.0||3.5||1.5|
|SACT and radiotherapy||1.8||7.1||24.4||25.1||19.6|
|Untreated (ie, none of the above)||6.9||8.0||9.5||14.5||24.1|
|SACT regimen in initial treatment, %||12.1||42.4||61.0||64.3||55.4|
|No SACT in initial treatment, %||87.9||57.6||39.0||35.7||44.6|