A multicenter survey of first-line treatment patterns and gene aberration test status of patients with unresectable Stage IIIB/IV nonsquamous non-small cell lung cancer in China (CTONG 1506)

• Published in: BMC cancer Vol. 17; no. 1; p. 462
• Main Authors: Zhou, Qing, Song, Yong, Zhang, Xin, Chen, Gong-Yan, Zhong, Dian-Sheng, Yu, Zhuang, Yu, Ping, Zhang, Yi-Ping, Chen, Jian-Hua, Hu, Yi, Feng, Guo-Sheng, Song, Xia, Shi, Qiang, Yang, Lu Lu, Zhang, Ping Hai, Wu, Yi-Long
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.07.2017; BioMed Central; BMC
• Subjects: Adenocarcinoma; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer therapies; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - epidemiology; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - therapy; Care and treatment; Chemotherapy; China; China - epidemiology; Chromosome abnormalities; Committees; Data entry; Demographics; Demography; Development and progression; Epidemiology; Epidermal growth factor; Epidermal growth factor receptor; Epidermal growth factor receptors; Female; First-line anticancer treatment; Gene fusion; Genetic aspects; Genetic Testing; Genetic Variation; Health aspects; Health Care Surveys; Histology; Hospitals; Humans; Innovations; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Lung Neoplasms - genetics; Lung Neoplasms - therapy; Lymphoma; Male; Metastases; Middle Aged; Molecular Targeted Therapy; Mutation; Neoplasm Metastasis; Neoplasm Staging; Non-small cell lung cancer; Non-small cell lung carcinoma; Oncology; Patients; Platinum; Practice Patterns, Physicians; Protein-tyrosine kinase; Studies; Tyrosine kinase inhibitor; China; First-line anticancer treatment; Chemotherapy; Tyrosine kinase inhibitor; China; Epidermal growth factor receptor; Non-small cell lung cancer
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-017-3451-x

In recent years, systemic chemotherapy and molecular targeted therapy have become standard first-line treatments for locally advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC). The objective of this survey was to investigate first-line anticancer treatment patterns and gene aberration test status of patients with advanced nonsquamous NSCLC in China. Patients included in this study had unresectable Stage IIIB/IV nonsquamous NSCLC and were admitted during August 2015 to March 2016 into one of 12 tertiary hospitals throughout China for first-line anticancer treatment. Patient data (demographics, NSCLC histologic type, Eastern Cooperative Oncology Group [ECOG] Performance Status [PS], gene aberration test and results [if performed], and first-line anticancer treatment regimen) were extracted from medical charts and entered into Medical Record Abstraction Forms (MERAFs), which were collated for analysis. Overall, 1041 MERAFs were collected and data from 932 MERAFs were included for analysis. Patients with unresectable Stage IIIB/IV nonsquamous NSCLC had a median age of 59 years, 56.4% were male, 58.2% were never smokers, 95.0% had adenocarcinoma, and 92.9% had an ECOG PS ≤1. A total of 665 (71.4%) patients had gene aberration tests; 46.5% (309/665) had epidermal growth factor receptor (EGFR) gene mutations, 11.5% (48/416) had anaplastic lymphoma kinase (ALK) gene fusions, and 0.8% (1/128) had a c-ros oncogene 1 gene fusion. The most common first-line treatment regimen for unresectable Stage IIIB/IV nonsquamous NSCLC was chemotherapy (72.5%, 676/932), followed by tyrosine kinase inhibitors (TKIs; 26.1%, 243/932), and TKIs plus chemotherapy (1.4%, 13/932). Most chemotherapy regimens were platinum-doublet regimens (93.5%, 631/676) and pemetrexed was the most common nonplatinum chemotherapy-backbone agent (70.2%, 443/631) in platinum-doublet regimens. Most EGFR mutation-positive patients (66.3%, 205/309) were treated with EGFR-TKIs. Findings from our survey of 12 tertiary hospitals throughout China showed an increased rate of gene aberration testing, compared with those rates reported in previous surveys, for patients with advanced nonsquamous NSCLC. In addition, pemetrexed/platinum-doublet chemotherapy was the predominant first-line chemotherapy regimen for this population. Most patients were treated based on their gene aberration test status and results.