CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2016; 37(04): 242-250
DOI: 10.4103/0971-5851.195735
ORIGINAL ARTICLE

Clinicopathological features and outcomes in advanced nonsmall cell lung cancer with tailored therapy

Stalin Bala
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Sadashivudu Gundeti
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Vijay Gandhi Linga
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Lakshmi Srinivas Maddali
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Raghunadha Rao Digumarti
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Shantveer G Uppin
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Context: Lung cancer is an important cause of cancer-related deaths worldwide. There is an increasing incidence of lung cancer in never smokers and a shift of histology from squamous cell to adenocarcinoma globally in the recent past. Data on treatment outcomes with newer platinum doublets is scant from India. Aims: To study the clinicopathological features, response rates (RRs), progression-free survival (PFS), overall survival (OS), and the 1, 2, and 3 years survival, in patients with advanced nonsmall cell lung cancer (NSCLC). Materials and Methods: Data of all patients who received chemotherapy for Stage IIIB and IV NSCLC between January 2010 and June 2014 were retrospectively analyzed. Statistical Analysis Used: Univariate analysis for OS was done by plotting Kaplan–Meier curves and the log-rank test was used to calculate P values. Logistic regression analysis for OS was carried out using MedCalc statistical software. Results: A total of 353 patients received chemotherapy. Of these, 256 were evaluable for outcome parameters. The median age at presentation was 58 years with a male:female ratio of 2.53:1. The smoker:nonsmoker ratio was 1:1. Adenocarcinomatous histology was the most common both in smokers and nonsmokers reported in 70.8% patients. Epidermal growth factor receptor (EGFR) mutation and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase translocation were seen in 35% and 3% of patients, respectively. The RR, median PFS, OS, 1, 2, and 3 years survival were 80%, 8 months, 12.1 months, 51.5%, 12.7%, and 4.2%, respectively. There was no significant survival difference among the treatment regimen used but the response to I line chemotherapy impacted survival. Female gender, performance status, and nonsquamous histology were significant predictors of OS (P = 0.0443, P = 0.0003, P = 0.048, respectively). Conclusions: There was an increase in the incidence of nonsmokers. Adenocarcinoma was the most common histology in both smokers and nonsmokers. Treatment outcomes in advanced lung cancer were better compared to the past with the advent of newer platinum doublets and EGFR tyrosine kinase inhibitors. The response to first-line chemotherapy significantly impacts outcomes in advanced NSCLC.



Publication History

Article published online:
12 July 2021

© 2016. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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