Jair Bar1,2, Damien Urban1,2, Uri Amit3, Sarit Appel3, Amir Onn4, Ofer Margalit1,2, Tamar Beller1, Teodor Kuznetsov1, Yaacov Lawrence2,3,5. 1. Institute of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5262000, Israel. 2. Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel. 3. Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5262000, Israel. 4. Pulmonology Institute, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 5262000, Israel. 5. Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Abstract
OBJECTIVE: Novel therapeutics and supportive care improved outcomes for metastatic non-small-cell lung cancer (mNSCLC) patients. Major advances over the past five decades include the introduction of combination chemotherapy, small molecules targeting mutant proteins, especially EGFR, and more recently immunotherapy. We aim to document real-world long-term survival over the past five decades. METHODS: Survival statistics were extracted from the Survival, Epidemiology, and End Results (SEER) database for mNSCLC patients during 1973-2015. Two- and five-year survival (2yS and 5yS) were analyzed using Kaplan-Meier and proportional hazard models. RESULTS: The study population consisted of 280,655mNSCLC patients diagnosed during 1973-2015. Longer survival was seen in younger, female, married, Asian/Pacific Islander race, adenocarcinoma, lower grade, more recent diagnosis, higher income, and chemotherapy-treated patients. 2yS increased during the study period from 2.6% to 12.9%, and 5yS increased from 0.7% to 3.2%. 2yS of patients <50 years of age rose from 2.1% to 22.8%, and their 5yS rose from 0.7% to 6.2%. 2yS of adenocarcinoma patients improved from 2.7% to 16.2%, and their improved 5yS from 1.1% to 3.9%. CONCLUSIONS: Between 1973 and 2015, there was a dramatic improvement in long-term survival, with an approximately five-fold increase in both 2yS and 5yS. Nonetheless, absolute numbers of long-term survivors remained low, with less than 4% living 5 years. This provides a baseline to compare long-term outcomes seen in the current generation of clinical trials.
OBJECTIVE: Novel therapeutics and supportive care improved outcomes for metastatic non-small-cell lung cancer (mNSCLC) patients. Major advances over the past five decades include the introduction of combination chemotherapy, small molecules targeting mutant proteins, especially EGFR, and more recently immunotherapy. We aim to document real-world long-term survival over the past five decades. METHODS: Survival statistics were extracted from the Survival, Epidemiology, and End Results (SEER) database for mNSCLC patients during 1973-2015. Two- and five-year survival (2yS and 5yS) were analyzed using Kaplan-Meier and proportional hazard models. RESULTS: The study population consisted of 280,655mNSCLC patients diagnosed during 1973-2015. Longer survival was seen in younger, female, married, Asian/Pacific Islander race, adenocarcinoma, lower grade, more recent diagnosis, higher income, and chemotherapy-treated patients. 2yS increased during the study period from 2.6% to 12.9%, and 5yS increased from 0.7% to 3.2%. 2yS of patients <50 years of age rose from 2.1% to 22.8%, and their 5yS rose from 0.7% to 6.2%. 2yS of adenocarcinoma patients improved from 2.7% to 16.2%, and their improved 5yS from 1.1% to 3.9%. CONCLUSIONS: Between 1973 and 2015, there was a dramatic improvement in long-term survival, with an approximately five-fold increase in both 2yS and 5yS. Nonetheless, absolute numbers of long-term survivors remained low, with less than 4% living 5 years. This provides a baseline to compare long-term outcomes seen in the current generation of clinical trials.
Authors: Martin Reck; Delvys Rodríguez-Abreu; Andrew G Robinson; Rina Hui; Tibor Csőszi; Andrea Fülöp; Maya Gottfried; Nir Peled; Ali Tafreshi; Sinead Cuffe; Mary O'Brien; Suman Rao; Katsuyuki Hotta; Kristel Vandormael; Antonio Riccio; Jing Yang; M Catherine Pietanza; Julie R Brahmer Journal: J Clin Oncol Date: 2019-01-08 Impact factor: 44.544
Authors: Akihiko Yoshizawa; Noriko Motoi; Gregory J Riely; Cami S Sima; William L Gerald; Mark G Kris; Bernard J Park; Valerie W Rusch; William D Travis Journal: Mod Pathol Date: 2011-01-21 Impact factor: 7.842
Authors: Claudia Allemani; Tomohiro Matsuda; Veronica Di Carlo; Rhea Harewood; Melissa Matz; Maja Nikšić; Audrey Bonaventure; Mikhail Valkov; Christopher J Johnson; Jacques Estève; Olufemi J Ogunbiyi; Gulnar Azevedo E Silva; Wan-Qing Chen; Sultan Eser; Gerda Engholm; Charles A Stiller; Alain Monnereau; Ryan R Woods; Otto Visser; Gek Hsiang Lim; Joanne Aitken; Hannah K Weir; Michel P Coleman Journal: Lancet Date: 2018-01-31 Impact factor: 79.321
Authors: Lisa R Shugarman; Katherine Mack; Melony E S Sorbero; Haijun Tian; Arvind K Jain; J Scott Ashwood; Steven M Asch Journal: Med Care Date: 2009-07 Impact factor: 2.983
Authors: Brenda K Edwards; Anne-Michelle Noone; Angela B Mariotto; Edgar P Simard; Francis P Boscoe; S Jane Henley; Ahmedin Jemal; Hyunsoon Cho; Robert N Anderson; Betsy A Kohler; Christie R Eheman; Elizabeth M Ward Journal: Cancer Date: 2013-12-16 Impact factor: 6.860
Authors: Daniel R Gomez; George R Blumenschein; J Jack Lee; Mike Hernandez; Rong Ye; D Ross Camidge; Robert C Doebele; Ferdinandos Skoulidis; Laurie E Gaspar; Don L Gibbons; Jose A Karam; Brian D Kavanagh; Chad Tang; Ritsuko Komaki; Alexander V Louie; David A Palma; Anne S Tsao; Boris Sepesi; William N William; Jianjun Zhang; Qiuling Shi; Xin Shelley Wang; Stephen G Swisher; John V Heymach Journal: Lancet Oncol Date: 2016-10-24 Impact factor: 41.316
Authors: Greta Bütepage; Peter Carlqvist; Johanna Jacob; Asbjørn Toft Hornemann; Simona Vertuani Journal: BMC Public Health Date: 2022-10-14 Impact factor: 4.135