Advanced non‑squamous NSCLC with no actionable oncogenic driver in Spain: a cross‑sectional descriptive analysis of data from the Thoracic Tumor Registry

• Enric Carcereny ^[14] ; Delvys Rodriguez Abreu ^[1] ; Rafael Lopez ^[2] ; Fabio Franco ^[15] ; Maria Guirado ^[3] ; Bartomeu Massutí ^[4] ; Manuel Cobo ^[5] ; Ana Blasco ^[6] ; Guillermo Suay ^[16] ; Edel del Barco ^[7] ; Ana Laura Ortega ^[8] ; Maria Angeles Sala ^[17] ; Patricia Cordeiro ^[9] ; Reyes Bernabé ^[10] ; José Luís González Larriba ^[11] ; Joaquim Bosch Barrera ^[18] ; Julia Calzas ^[12] ; Joaquín Casal ^[13] ; Airam Padilla ^[19] ; Alfredo Sánchez Hernandez ^[20] ; Mariano Provencio ^[15]
  1. [1] Complejo Hospitalario Universitario Insular - Materno Infantil de Canarias

     Complejo Hospitalario Universitario Insular - Materno Infantil de Canarias

     Gran Canaria, España

     
  2. [2] Hospital Universitario de Valladolid

     Hospital Universitario de Valladolid

     Valladolid, España

     
  3. [3] Hospital General Universitario de Elche

     Hospital General Universitario de Elche

     Elche, España

     
  4. [4] Hospital General Universitario de Alicante

     Hospital General Universitario de Alicante

     Alicante, España

     
  5. [5] Hospital Regional Universitario de Málaga

     Hospital Regional Universitario de Málaga

     Málaga, España

     
  6. [6] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  7. [7] Hospital Universitario de Salamanca

     Hospital Universitario de Salamanca

     Salamanca, España

     
  8. [8] Hospital Universitario de Jaén

     Hospital Universitario de Jaén

     Jaén, España

     
  9. [9] Complexo Hospitalario Universitario da Coruña

     Complexo Hospitalario Universitario da Coruña

     A Coruña, España

     
  10. [10] Hospital Universitario Virgen del Rocío

      Hospital Universitario Virgen del Rocío

      Sevilla, España

      
  11. [11] Hospital Clínico San Carlos de Madrid

      Hospital Clínico San Carlos de Madrid

      Madrid, España

      
  12. [12] Hospital de Fuenlabrada

      Hospital de Fuenlabrada

      Fuenlabrada, España

      
  13. [13] Complexo Hospitalario Universitario de Vigo

      Complexo Hospitalario Universitario de Vigo

      Vigo, España

      
  14. [14] Institut Català D’oncologia Badalona- Hospital Germans Trias I Pujol, B-Argo Group, Badalona, Spain
  15. [15] Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
  16. [16] Hospital Universitari I Politècnic La Fe, Valencia, Spain
  17. [17] OSI Bilbao Basurto, Bilbao, Spain
  18. [18] Josep Trueta and Precision Oncology Group (OncoGIR-Pro), Institut d’Investigacions Biomèdiques de Girona (IDIBGI), Catalan Institute of Oncology, Hospital Universitari Dr, Girona, Spain
  19. [19] Hospital Universitario, Nuestra Señora De La Candelaria, Santa Cruz de Tenerife, Spain
  20. [20] Hospital Provincial de Castellón, Castellón, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 12, 2024, págs. 3218-3225
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background Non-small cell lung cancer (NSCLC) accounts for the vast majority of all diagnosed lung cancers. According to their histology, most NSCLCs are considered non-squamous cell carcinoma (NSCC), and up to 85% of the latter may lack either one of the two main actionable oncogenic drivers (i.e., EGFR mutations and ALK rearrangements).

    Objective Our analysis aimed to describe the clinical and epidemiological characteristics of Spanish patients sufering from NSCC with no actionable oncogenic driver in daily clinical practice. Design A retrospective, cross-sectional, descriptive analysis.

    Methods We analyzed the records of all Spanish patients with advanced NSCC diagnosed between January 2011 and January 2020 and included in the Spanish Thoracic Tumor Registry database. We evaluated the presence of metastasis and molecular profling at the time of diagnosis and treatments received. We also assessed overall survival (OS) and progression-free survival (PFS) according to frst-line treatment.

    Results One thousand seven hundred ninety-seven Spanish patients with NSCC were included. They were mainly men (73.2%), smokers (current [44.4%] and former [44.4%]) and presented adenocarcinoma histology (97.6%). Most patients had at least one comorbidity (80.4%) and one metastatic site (96.8%), and a non-negligible number of those tested were PD-L1 positive (35.2%). Notably, the presence of liver metastasis indicated a shorter median OS and PFS than metastasis in other locations (p<0.001). Chemotherapy was more often prescribed than immunotherapy as frst-, second-, and third-line treatment in that period. In frst-line, the OS rates were similar in patients receiving either regimen, but PFS rates signifcantly better in patients treated with immunotherapy (p=0.026). Also, a high number of patients did not reach second- and thirdline treatment, suggesting the failure of current early diagnostic measures and therapies.

    Conclusions This analysis of the most lethal tumor in Spain could highlight the strengths and the weaknesses of its clinical management and set the ground for further advances and research.