Background: Recent clinical trials support adjuvant treatment with novel immunotherapy and targeted therapy agents for selected non-small-cell lung cancer (NSCLC) after resection. The “real-world” implementation of these treatments, however, remains unknown. This study evaluated trends in the uptake of adjuvant chemotherapy, immunotherapy, and targeted therapy for patients with resected NSCLC.Methods: Patients with resected stage IB-III NSCLC within the Veterans Health Administration (2017−2023) were included. Use of adjuvant chemotherapy, immunotherapy, and/or targeted therapy was evaluated over the study period. Factors associated with adjuvant therapy use were identified using multivariable-adjusted logistic regression.Results: Of the 1980 patients included, 846 (42.7%) underwent adjuvant therapy. There was a modest but not statistically significant increase in adjuvant therapy use from 37.1% in 2017 to 45.9% in 2023. Use of adjuvant chemotherapy alone declined from 36.6% to 23.5%, while use of adjuvant immunotherapy (0.5% to 21.2%) and targeted therapy (0% to 1.2%) increased. Factors associated with adjuvant therapy use included younger age, fewer comorbidities, and higher tumor stage.Conclusions: Despite the increased use of adjuvant immunotherapy and targeted therapy for resected stage IB-III NSCLC, overall adjuvant therapy uptake remains low. Further efforts will be necessary to better incorporate these novel treatments into routine clinical practice.
背景：近期临床试验支持对特定非小细胞肺癌（NSCLC）切除术后患者采用新型免疫疗法和靶向治疗药物进行辅助治疗。然而，这些治疗在“真实世界”中的实施情况仍不明确。本研究评估了NSCLC切除术后患者接受辅助化疗、免疫治疗及靶向治疗的应用趋势。 方法：本研究纳入美国退伍军人健康管理局系统中2017年至2023年间接受手术切除的IB-III期NSCLC患者。通过多变量调整逻辑回归分析，评估研究期间辅助化疗、免疫治疗和/或靶向治疗的应用情况，并识别与辅助治疗使用相关的因素。 结果：在纳入的1980例患者中，846例（42.7%）接受了辅助治疗。辅助治疗使用率从2017年的37.1%小幅上升至2023年的45.9%，但无统计学显著性。单纯辅助化疗使用率从36.6%下降至23.5%，而辅助免疫治疗（0.5%至21.2%）和靶向治疗（0%至1.2%）使用率有所上升。与辅助治疗使用相关的因素包括年龄较轻、合并症较少及肿瘤分期较高。 结论：尽管IB-III期NSCLC切除术后辅助免疫治疗和靶向治疗的应用有所增加，但总体辅助治疗使用率仍然偏低。未来需进一步努力，以更好地将这些新型治疗纳入常规临床实践。
Real-World Adoption of Adjuvant Therapies for Resected Stage IB–III Non-Small-Cell Lung Cancer
肿瘤(癌症)患者之家