This was a retrospective study of the profile and initial treatments of adults diagnosed with early-stage (ES) non-small cell lung cancer (NSCLC) during January 2018–December 2021 at 16 leading hospital institutions in Austria, excluding patients enrolled in clinical trials. In total, 319 patients were enrolled at a planned ~1:1:1 ratio across StI:II:III. Most tested biomarkers were programmed death ligand 1 (PD-L1; 58% expressing), Kirsten rat sarcoma virus (KRAS; 22% positive), and epidermal growth factor receptor (EGFR; 18% positive). Of 115/98/106 StI/II/III patients, 82%/85%/36% underwent surgery, followed by systemic therapy in 9%/45%/47% of those [mostly chemotherapy (ChT)]. Unresected treated StIII patients received ChT + radiotherapy [43%; followed by immune checkpoint inhibitors (ICIs) in 39% of those], ICI ± ChT (35%), and ChT-alone/radiotherapy-alone (22%). Treatment was initiated a median (interquartile range) of 24 (7–39) days after histological confirmation, and 55 (38–81) days after first medical visit. Based on exploratory analyses of all patients newly diagnosed with any stage NSCLC during 2018–2021 at 14 of the sites (N = 7846), 22%/10%/25%/43% had StI/II/III/IV. The total number was not significantly different between pre-COVID-19 (2018–2019) and study-specific COVID-19 (2020–2021) periods, while StI proportion increased (21% vs. 23%;p= 0.012). Small differences were noted in treatments. In conclusion, treatments were aligned with guideline recommendations at a time which preceded the era of ICIs and targeted therapies in the (neo)adjuvant setting.
本研究为一项回顾性分析，旨在探讨2018年1月至2021年12月期间奥地利16家领先医疗机构诊断为早期非小细胞肺癌成年患者的临床特征及初始治疗方案，排除了参与临床试验的患者。研究共纳入319例患者，按计划以约1:1:1的比例分布于I期、II期和III期。检测的主要生物标志物包括程序性死亡配体1（PD-L1；阳性表达率为58%）、Kirsten大鼠肉瘤病毒（KRAS；阳性率为22%）和表皮生长因子受体（EGFR；阳性率为18%）。在115例I期、98例II期和106例III期患者中，分别有82%、85%和36%接受了手术治疗，术后分别有9%、45%和47%的患者接受了全身治疗[主要为化疗]。未接受手术治疗的III期患者中，43%接受了化疗联合放疗[其中39%后续接受了免疫检查点抑制剂治疗]，35%接受了免疫检查点抑制剂联合或不联合化疗，22%接受了单纯化疗或单纯放疗。治疗启动的中位时间（四分位距）分别为组织学确诊后24天（7-39天）及首次就诊后55天（38-81天）。基于对2018-2021年间14个研究中心所有新诊断非小细胞肺癌患者（N=7846）的探索性分析，I期、II期、III期和IV期患者占比分别为22%、10%、25%和43%。新冠疫情前（2018-2019年）与研究涵盖的疫情期间（2020-2021年）患者总数无显著差异，但I期患者比例有所增加（21% vs. 23%；p=0.012），治疗方案存在微小差异。综上所述，在免疫检查点抑制剂和靶向治疗尚未广泛应用于（新）辅助治疗的时代，本研究的治疗方案与指南推荐基本一致。
肿瘤(癌症)患者之家