Survival Outcomes in Advanced Non-Small Cell Lung Cancer in a Cancer Center in Medellin - Colombia

Abstract

Introduction: survival outcomes of Non-Small Cell Lung Cancer (NSCLC) reported in the literature may not apply to patients in a real-life scenario in Colombia. This study aims to describe these in a cohort of patients with NSCLC treated at Clínica de Oncología Astorga, in Medellín, Colombia. Methods: this is an observational study with survival analysis. Patients with advanced NSCLC established from January 1/2019 treated at the Institution were included. Medical records were analyzed retrospectively. Kaplan Meier method was used to estimate progression-free survival (PFS) and overall survival (OS). To compare the survival distributions log-rank test was performed. Results: fifty-two patients were included. Median age was 70.1 years (IQR:64.6-77.2). Adenocarcinoma in 57.7%. First-line treatment was chemotherapy (48.1%), immunotherapy (40.4%), and anti-ALK/EGFR tyrosine-kinase inhibitors (TKI) (9.6%). One patient was enrolled in a clinical trial. Median PFS and OS for the entire cohort were 6.0 months (95%CI:4.8-7.1) and 11 months (95%CI:6.7-15.3), respectively. Median OS for performance-status (PS) 1-2 was 14.5 months (95%CI:7.3-21.7) and 4.7 months (95%CI:2.7-6.7) for PS 2-4 (P=0.002). Median PFS for chemotherapy, immunotherapy, and TKI were 3.3 months (95%CI:0.8-5.8), 9.9 months (95%CI:4.6-15.2), and not reached, respectively (P<0.001). Median OS for chemotherapy, immunotherapy, and TKI were 6.0 months (95%CI:1.9-10.0), 9.9 months (95%CI:8.1-11.8), and not reached, respectively (P=0.080). Conclusion: clinical outcomes in Real-World-Setting in advanced NSCLC in Colombia, a Low-Middle-Income-Country, can better inform patients and providers in regards to setting-specific survival expectations. Advanced disease with poor PS and lack of access to state-of-art therapy are challenges yet to be addressed.