PMID- 37324065
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231102
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 15
IP  - 5
DP  - 2023 May 30
TI  - Analysis of real-world data to investigate evolving treatment sequencing patterns 
      in advanced non-small cell lung cancers and their impact on survival.
PG  - 2438-2449
LID - 10.21037/jtd-22-1481 [doi]
AB  - BACKGROUND: Although optimal sequencing of systemic therapy in cancer care is 
      critical to achieving maximal clinical benefit, there is a lack of analysis of 
      treatment sequencing in advanced non-small cell lung cancer (aNSCLC) in 
      real-world settings. METHODS: A retrospective cohort study of 13,340 lung cancer 
      patients within the Mount Sinai Health System (MSHS) was performed. Systemic 
      therapy data of aNSCLC in 2,106 patients was the starting point in our analysis 
      to investigate how treatment sequencing has evolved, the impact of sequencing 
      patterns on clinical outcomes, and the effectiveness of 2(nd) line chemotherapy 
      after patients progressed on immune checkpoint inhibitor (ICI)-based therapy as 
      the 1(st) line of therapy (LOT). RESULTS: There is a significant shift to more 
      ICI-based therapy and multiple lines of targeted therapy after 2015. We compared 
      clinical outcomes of two patient populations with different treatment sequencing 
      patterns, with the 1(st) group receiving chemotherapy as the 1(st) LOT followed 
      by ICI-based treatment, and the 2(nd) group treated in the opposite order 
      receiving a 1(st) line ICI-containing regimen followed by a 2(nd) line 
      chemotherapy. No statistically significant difference in overall survival (OS) 
      was observed between the two groups [group 2 vs. group 1, adjusted hazard ratio 
      (aHR) =1.36, P=0.39]. We assessed the efficacy of the 2(nd) line chemotherapy in 
      three patient populations given either 1(st) line ICI single agent, 1(st) line 
      ICI-chemotherapy combination, or 1(st) line chemotherapy alone, there was no 
      statistically significant difference in time-to-next treatment (TTNT) and in OS 
      among the three patient groups. CONCLUSIONS: Analysis of real-world data has 
      shown two treatment sequencing patterns in aNSCLC, ICI followed by chemotherapy 
      or chemotherapy followed by ICI, achieved similar clinical benefit. The 
      chemotherapies routinely used following platinum doublet 1(st) LOT, is effective 
      as the 2(nd) line option after ICI-chemotherapy combination in the 1(st) line 
      setting.
CI  - 2023 Journal of Thoracic Disease. All rights reserved.
FAU - Liu, Zongzhi
AU  - Liu Z
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Lee, Kyeryoung
AU  - Lee K
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Cohn, David
AU  - Cohn D
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Zhang, Mingwei
AU  - Zhang M
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Ai, Lei
AU  - Ai L
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Li, Minghao
AU  - Li M
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Zhang, Xingming
AU  - Zhang X
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Jun, Tomi
AU  - Jun T
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Higashi, Mitchell K
AU  - Higashi MK
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Pan, Qi
AU  - Pan Q
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Oh, William
AU  - Oh W
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Stolovitzky, Gustavo
AU  - Stolovitzky G
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Schadt, Eric
AU  - Schadt E
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
AD  - Icahn School of Medicine at Mount Sinai, New York, NY, USA.
FAU - Wang, Xiaoyan
AU  - Wang X
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
FAU - Li, Shuyu D
AU  - Li SD
AD  - Sema4 Mount Sinai Genomic Inc., Stamford, CT, USA.
LA  - eng
PT  - Journal Article
DEP - 20230406
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
CIN - J Thorac Dis. 2023 Jul 31;15(7):3554-3556. PMID: 37559596
PMC - PMC10267939
OTO - NOTNLM
OT  - Advanced non-small cell lung cancer (aNSCLC)
OT  - immune checkpoint inhibitors (ICIs)
OT  - line of therapy (LOT)
OT  - optimal treatment sequencing
OT  - real world evidence
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jtd.amegroups.com/article/view/10.21037/jtd-22-1481/coif). MKH and QP 
      have been employees of the Sema4 Mount Sinai Genomics. The other authors were 
      employees of the Sema4 Mount Sinai Genomics. DC also claims employment by Pfizer. 
      The authors have no other conflicts of interest to declare.
EDAT- 2023/06/16 06:42
MHDA- 2023/06/16 06:43
PMCR- 2023/05/30
CRDT- 2023/06/16 04:06
PHST- 2022/10/19 00:00 [received]
PHST- 2023/03/10 00:00 [accepted]
PHST- 2023/06/16 06:43 [medline]
PHST- 2023/06/16 06:42 [pubmed]
PHST- 2023/06/16 04:06 [entrez]
PHST- 2023/05/30 00:00 [pmc-release]
AID - jtd-15-05-2438 [pii]
AID - 10.21037/jtd-22-1481 [doi]
PST - ppublish
SO  - J Thorac Dis. 2023 May 30;15(5):2438-2449. doi: 10.21037/jtd-22-1481. Epub 2023 
      Apr 6.