WCLC 2025 - Posters & ePosters-P1.17.05 Evolution of Neoadjuvant Treatment for Non Small Cell Lung Cancer (NSCLC) in Brazil: An Analysis From the Brazilian Lung Cancer Registry

P1.17.05 Evolution of Neoadjuvant Treatment for Non Small Cell Lung Cancer (NSCLC) in Brazil: An Analysis From the Brazilian Lung Cancer Registry

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This retrospective multicenter study analyzed the evolution and impact of neoadjuvant therapy for non-small cell lung cancer (NSCLC) in Brazil from 2010 to 2024, using data from the Brazilian Lung Cancer Registry. Of 3132 patients screened, 574 with clinical stages IIA-IIIB NSCLC were included; 84 received neoadjuvant therapy and 490 underwent upfront surgery. The study assessed adoption trends, treatment characteristics, and survival outcomes.<br /><br />Findings show a significant increase in neoadjuvant therapy use in Brazil after 2020, mirroring global publication trends and research advances. However, overall adoption remains limited, with clear disparities between sectors: patients in private health systems were nearly three times more likely to receive neoadjuvant therapy than those in the public system. Neoadjuvant therapy was more commonly used in higher clinical stages (IIIB, IIIA) and correlated with greater tumor downstaging compared to upfront surgery.<br /><br />Surgical approaches (thoracotomy, VATS, RATS), lung resection types, and operative time did not differ significantly between treatment groups, though thoracoscopic approaches were somewhat more frequent in neoadjuvant cases. Histological subtype distribution showed a higher proportion of adenocarcinoma among neoadjuvant patients.<br /><br />Survival analysis revealed no statistically significant improvement in overall survival between neoadjuvant therapy and upfront surgery groups, despite the observed downstaging. Limitations include the retrospective design, sampling bias toward reference centers, and limited sample size.<br /><br />The study concludes that while neoadjuvant therapy adoption in Brazil is increasing, substantial institutional and socioeconomic barriers persist, particularly within the public health system. These disparities highlight the urgent need to improve equitable access to guideline-recommended NSCLC care to optimize patient outcomes nationwide.

Asset Subtitle

Ricardo Terra

Meta Tag

Speaker Ricardo Terra

Topic Global Health, Health Services, and Health Economics

Keywords

neoadjuvant therapy

non-small cell lung cancer

NSCLC

Brazil

clinical stages IIA-IIIB

lung cancer registry

treatment adoption trends

tumor downstaging

survival outcomes

healthcare disparities