The survival rates of patients with advanced non–small cell lung cancer (NSCLC) have improved since the introduction of the first immunotherapeutic in this population in the United States in 2015, according to a recent study published by Wang et al in Cancer. NSCLC accounts for up to 90% of all lung cancer cases and is the leading cause of cancer-related mortality among male and female patients in the United States.
Study Methods and Results
In the recent real-world study, investigators used the National Cancer Institute Surveillance, Epidemiology, and End Results database—which compiles cancer-related data covering approximately 48% of the U.S. population—to examine the survival rates of 100,995 patients with metastatic NSCLC who received treatment after immunotherapy was deemed the standard of care between 2015 and 2020 and 90,807 patients with metastatic NSCLC who received treatment in the preimmunotherapy era between 2010 and 2014.
The investigators found that the patients treated in the immunotherapy era were less likely to experience all-cause mortality. Compared with those who received treatment in the preimmunotherapy era, the overall survival rates among the patients who received treatment in the immunotherapy era at 1, 3, and 5 years were 40.1% vs 33.5%, 17.8% vs 11.7%, and 10.7% vs 6.8%, respectively. The median overall survival was 8 months among the patients in the immunotherapy era and 7 months among those in the preimmunotherapy era.
Similarly, the patients treated after immunotherapy became available were less likely to die specifically from cancer compared with those treated before immunotherapy was available. The 1-, 3-, and 5-year cancer-specific survival rates were 44.0% vs 36.8%, 21.7% vs 14.4%, and 14.3% vs 9.0%, respectively, with a median survival of 10 months vs 8 months.
The investigators reported that the survival rates remained significantly higher in the immunotherapy era, even after accounting for factors such as age, sex, race, income, and geographic area.
Conclusions
“By utilizing a large national database, our study provided real-world evidence of the positive impact of immunotherapy in patients with lung cancer,” emphasized senior study author Dipesh Uprety, MD, FACP, of the Barbara Ann Karmanos Cancer Institute and the Wayne State University School of Medicine. The investigators stressed that additional studies may be needed to more fully understand the findings.
“Immunotherapy provides long-term benefits. Since the durable benefits of immunotherapy are limited to a small subset of patients, future research should aim to optimize immunotherapy with new agents that can benefit a broader population,” concluded lead study author Yating Wang, MD, of Ascension Providence Hospital.
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
