January 15, 2019
1 min read

Treatment at academic centers yields survival benefit in metastatic NSCLC

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Patients with metastatic non-small cell lung cancer who received treatment at academic centers demonstrated significantly better 2-year survival rates than patients who were treated at community centers, according to results of a retrospective analysis.

The survival benefit was particularly evident among patients with adenocarcinoma vs. squamous cell carcinoma.

“Given known advances in adenocarcinoma treatment compared with squamous cell lung cancer [between 1998 and 2010], our study suggests potential treatment-related disparities may exist between academic centers and community centers,” Sendhilnathan Ramalingam, MD, trainee in the department of hematology-oncology at Duke Cancer Institute, and colleagues wrote.

Ramalingam and colleagues used the National Cancer Database to examine whether treatment received at an academic center was linked to a survival advantage after the introduction of novel targeted therapies between 1998 and 2010 that require a molecularly driven, histologically specific approach.

The study included 193,279 patients (mean age, 63.5 years; 56.7% men; 84.3% white) with clinical or pathologic stage IV NSCLC.

The primary endpoint was 2-year survival — assessed by multivariable regression model controlling for age, year of diagnosis, gender, primary payer, histology, facility type and an interaction term allowing a time-based comparison between academic and community centers.

Two-year survival was 11.5% among patients who received treatment at academic centers and 9.2% among those who received treatment at community centers in 1998.

By 2010, 2-year survival increased to 17.4% among those treated at academic centers and 13.1% among those treated at community centers.

Results of multivariable analysis confirmed a significant relative increase in 2-year survival associated with academic centers vs. community centers from 1998 to 2010 (P = .0005).

Researchers also observed a difference in histology-dependent survival between patients with adenocarcinoma vs. squamous cell carcinoma (10.2% vs. 9.9% in 1998; 17.3% vs. 10.1% in 2010).

From 1998 to 2010, 2-year survival among patients with adenocarcinoma increased from 12.3% to 20.5% across academic centers and from 9.1% to 15.5% across community centers. Researchers observed a trend toward significance in a multivariable model (P = .005).

“Further study will be needed to validate this disparity in health care and address opportunities to improve survival in stage IV NSCLC patients across treatment setting,” Ramalingam and colleagues wrote. – by Jennifer Southall

Disclosures: All authors report no relevant financial disclosures.