Effectiveness of first-line anticancer treatment may predict treatment response in further lines in stage III/IV patients with non-small cell lung cancer

Authors

BRATOVÁ Monika SKŘIČKOVÁ Jana MATUSIKOVA Magda HRABCOVA Karolina HAVEL Libor KOUBKOVA Leona HRNCIARIK Michal KREJCI Jana FISCHER Ondrej SVATON Martin BRAT Kristián

Year of publication 2023
Type Article in Periodical
Magazine / Source Journal of cancer research and clinical oncology
MU Faculty or unit

Faculty of Medicine

Citation
Web https://link.springer.com/article/10.1007/s00432-023-05431-5
Doi http://dx.doi.org/10.1007/s00432-023-05431-5
Keywords Non-small cell lung cancer; Anticancer treatment; Effectiveness; Overall survival; Progression-free survival
Description PurposeThe aim of our study was to evaluate if therapeutic success in the first-line of anticancer treatments in patients with NSCLC may predict treatment success in the following lines.MethodsWe analyzed the data of patients with NSCLC stage III/IV from the TULUNG registry separately for chemotherapy, TKIs, ALK inhibitors, and immunotherapy in the first line during the years 2011-2019. ,,Succesful treatment " was defined as PFS >= 6 months, a ,,good responder " was a patient with >50% of ,,successful treatment " lines. Treatment responses were analyzed separately for each drug group. Descriptive statistics, Fisher exact test, Pearson Chi-Squared test, log-rank test, and univariate/multivariate logistic regression models were used.ResultsThe first-line TKI therapy was successful in 66.2%, while good responders accounted for 50.7% of the cohort and their rates were similar for all types of TKIs. First-line platinum-based chemotherapy was successful in 43.1% and 48.6% for combinations with pemetrexed and bevacizumab, respectively. Good responders accounted for 29.5% and 25.9%, respectively. In the group of ALK inhibitors, we observed treatment success in 52.3% of cases, while alectinib showed the highest effectiveness (up to 70%). Good responders constituted 50% of the group. In the first-line immunotherapy group, survival benefit was observed in 52.3%, and good responders constituted 52.3% of the cohort.ConclusionWe concluded that the treatment success in first-line therapies in patients with NSCLC may predict survival benefits in the subsequent lines, particularly in EGFR- or ALK-positive disease and immunotherapy-treated patients.

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