2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07D.04 Outcomes with Evolving Patterns of Neoadjuvant Therapy: A Population-Based Analysis

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The study examines trends and outcomes associated with neoadjuvant therapy in patients undergoing surgical resection for locally-advanced non-small cell lung cancer (NSCLC), using data from the Mid-South Quality of Surgical Resection cohort (2009-2023). The cohort included 6,137 patients from hospitals in Arkansas, Mississippi, and Tennessee. The neoadjuvant therapies were classified into systemic therapy (chemotherapy and/or immunotherapy), radiation therapy only, and chemoradiation. <br /><br />Findings indicate a substantial increase in the use of systemic therapy, which rose from 4% in 2021 to 12% in 2023. Conversely, the use of chemoradiation decreased from 4% in 2009 to 1% in 2023. This shift is attributed largely to the expanding role of neoadjuvant chemo-immunotherapy.<br /><br />Survival analysis, utilizing Cox proportional hazards model adjustments for age, sex, race, clinical stage, and extent of resection, revealed that systemic therapy is associated with improved survival outcomes compared to primary surgical resection alone (adjusted Hazard Ratio (aHR): 0.762, p=0.0479). In contrast, chemoradiation was associated with higher mortality risk (aHR: 1.503, p<0.0001), while neoadjuvant radiation therapy alone showed no significant survival benefit.<br /><br />The study concludes that the adoption of neoadjuvant systemic therapy, particularly chemo-immunotherapy regimens, has significantly increased, correlating with better survival rates, while the use of chemoradiation is diminishing due to its association with poorer outcomes. Further research is warranted to refine these findings and to explore the specific regimens contributing to these trends.<br /><br />The study was conducted by a collaboration of researchers from the Baptist Cancer Center's Thoracic Oncology Research Group and other institutions, with Olawale Akinbobola serving as the lead author. Correspondence can be directed to Raymond Osarogiagbon at the Baptist Cancer Center.

Asset Subtitle

Olawale Akinbobola

Meta Tag

Speaker Olawale Akinbobola

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

neoadjuvant therapy

non-small cell lung cancer

systemic therapy

chemoradiation

survival outcomes

Mid-South Quality cohort

chemo-immunotherapy

Cox proportional hazards

surgical resection

Baptist Cancer Center