OS for NSCLC has improved modestly during past 16 years

During the past 16 years, there has been a modest but statistically significant improvement in OS and PFS observed among patients with late-stage non–small cell lung cancer; advances may possibly be due to recent advances in diagnosis and therapy, according to researchers.

Using the SEER registry, researchers identified 129,337 patients aged older than 21 years had stage IV NSCLC and were diagnosed between 1990 and 2005. Patients were divided into four diagnostic periods: period one (1990-1993), period two (1994-1997), period three (1998-2001) or period four (2002-2005).

Median age of patients was 67.2 years and median follow-up was four months. Forty-one percent of patients had adenocarcinoma, 34% had other histologies, 17% had squamous cell carcinoma and 8% had large cell carcinoma.

Both one- and two-year OS rates improved from period one to period four. One-year OS was 13.2% in period one vs. 19.4% in period four; two-year OS was 4.5% in period one vs. 7.8% in period four.

Those with adenocarcinoma and squamous cell carcinoma had higher OS at one and two years vs. those with large cell carcinomas and other histologies, according to researchers.

In multivariate analysis, younger age, being a woman, ethnicity other than white or black, adenocarcinoma or squamous cell carcinoma histology and successive diagnostic periods were associated with better survival.

“Despite the drawbacks from analyzing retrospective database cohorts, our study [findings provide] insight into the changing outcomes in advanced NSCLC over time and the impact of recent advances in diagnosis and therapy beyond what has been learnt studying highly selected group[s] of patients enrolled in prospective studies,” researchers wrote.

“Although the development of several new agents led to a statistically significant survival improvement over the last 16 years, it is sobering that the one-year survival has improved by only 6% during this time,” they added.

Morgensztern D. J Thorac Oncol. 2009;4:1524-1529.