INAL RESEARCH Effectiveness of next-generation sequencing for patients with advanced non-small-cell lung cancer: a population-based registry study

被引：11

作者：

Kang, D. -W. ^{[1
]}

Park, S. -K. ^{[2
]}

Yu, Y. L. ^{[3
]}

Lee, Y. ^{[4
]}

Lee, D. H. ^{[5
]}

Kang, S. ^{[3
,6
,7
,8
]}

机构：

[1] Sungkyunkwan Univ, Sch Pharm, Suwon, South Korea

[2] Catholic Univ Korea, Coll Pharm, Bucheon, South Korea

[3] Natl Canc Ctr, Ctr Gynecol Canc, Res Inst & Hosp, Goyang, South Korea

[4] Natl Canc Ctr, Dept Internal Med, Goyang, South Korea

[5] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Oncol, Seoul, South Korea

[6] Natl Canc Ctr, Grad Sch Canc Sci & Policy, Dept Canc Control & Policy, Goyang, South Korea

[7] Natl Canc Ctr, Res Inst & Hosp, Ctr Gynecol Canc, 323 Ilsan Ro, Goyang Si, Gyeonggi Do, South Korea

[8] Natl Canc Ctr, Grad Sch Canc Sci & Policy, Dept Canc Control & Policy, 323 Ilsan Ro, Goyang Si, Gyeonggi Do, South Korea

来源：

ESMO OPEN | 2024年 / 9卷 / 01期

关键词：

next-generation sequencing; single-gene testing; non-small-cell lung cancer; distant metastasis; real-world evidence;

D O I：

10.1016/j.esmoop.2023.102200

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Despite the growing use of next-generation sequencing (NGS) in the management of advanced non-smallcell lung cancer (NSCLC), there is little evidence that its use leads to improved clinical outcomes. This study aimed to compare the effectiveness of NGS with that of single-gene testing (SGT) alone in patients with advanced NSCLC. Materials and methods: This was a retrospective cohort study conducted on patients diagnosed with advanced lung adenocarcinoma between 2017 and 2018 from a nationwide, population-based database. We identified patients who had SGT exclusively (SGT group) or underwent upfront NGS or NGS following SGT as an initial evaluation (NGS group). Patients were followed up until death or the end of the study (31 December 2019). The adjusted hazard ratio (aHR) for death was estimated using the Cox proportional hazards model. The factors affecting the adoption of NGS were identified. Results: Of 8566 patients diagnosed with advanced lung adenocarcinoma, 402 and 6932 patients were assigned to the NGS and SGT groups, respectively. More NGS was carried out in younger patients, those with higher incomes, and those living in urban areas. After balancing these confounders through matching, no difference was observed in the median overall survival and risk of death between the NGS and SGT groups [18.5 versus 19.7 months, log-rank P 1/4 0.783; aHR 0.98, 95% confidence interval (CI) 0.84-1.14, respectively]. Only in a subgroup for whom epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) inhibitors were not indicated, NGS was associated with better survival outcomes (14.1 versus 9.0 months, log-rank P 1/4 0.006; aHR 0.82, 95% CI 0.69-0.97). Conclusions: In the real world, NGS for all-comers in patients with advanced NSCLC did not increase survival outcomes. When health care resources to support equal access to NGS are limited, upfront SGT followed by NGS may be a more efficient strategy

引用

页数：7

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