WCLC 2025 - Posters & ePosters-EP.01.16 Differential Effect of Neoadjuvant Therapy in Locally Advanced Non-Small Cell Lung Cancer Based on Sex

EP.01.16 Differential Effect of Neoadjuvant Therapy in Locally Advanced Non-Small Cell Lung Cancer Based on Sex

Pdf Summary

This study investigates the impact of sex on outcomes for patients with locally advanced non-small cell lung cancer (LA-NSCLC) undergoing neoadjuvant therapy (NAT). Using data from the Flatiron Health Research Database, including 150 patients (62 females, 88 males) receiving different NAT types—chemotherapy alone (chemo), chemoradiation (chemo-RT), or chemoimmunotherapy (chemo-IO)—the researchers analyzed overall survival (OS) and progression-free survival (PFS) by sex and treatment.<br /><br />Key findings include that females had a 60% lower risk of death compared to males across the entire cohort (HR 0.40, p=0.037). When broken down by NAT type, no sex differences in OS or PFS were observed for patients receiving chemo alone or chemo-IO. However, among those treated with chemo-RT, females experienced significantly better OS than males (HR 0.07, p=0.014). Conversely, males receiving chemo-RT had worse OS compared to those treated with chemo alone. These outcomes persisted even after adjusting for tumor histology (squamous cell carcinoma versus non-squamous).<br /><br />The study concludes that sex is a significant biomarker for survival in LA-NSCLC receiving NAT. Females generally show improved survival, particularly with chemo-RT. Males receiving chemo-RT fare worse than when given chemo alone, highlighting a differential effect of therapy by sex. These findings underscore the importance of including sex in treatment outcome analyses and suggest that therapeutic strategies may need sex-specific tailoring.<br /><br />Future research directions include clinicogenomic analyses to understand biological reasons behind worse outcomes with chemo-RT in males and exploring sex as a biomarker in other cancers. Overall, the study advocates for sex-based considerations to optimize treatment in LA-NSCLC.

Asset Subtitle

Henry Park

Meta Tag

Speaker Henry Park

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

sex differences

locally advanced non-small cell lung cancer

neoadjuvant therapy

overall survival

progression-free survival

chemotherapy

chemoradiation

chemoimmunotherapy

sex-specific treatment outcomes

Flatiron Health Research Database