Real-World Treatment Patterns in Stage IB–IIIC NSCLC in China: Findings From the KEY-RAISE Study

In the multicenter, retrospective, observational KEY-RAISE study conducted across 10 sites in China, investigators evaluated real-world treatment patterns among 1,000 adult patients diagnosed with stage IB–IIIC non-small cell lung cancer (NSCLC) between January 1, 2019, and December 31, 2021, with follow-up through June 30, 2023. The patient population had a mean age of 60.4 years, was predominantly male (69.6%), and included 52.9% current or former smokers, 64.0% with non-squamous cell histology, and 54.8% with clinical stage III disease.

Among the overall cohort, 761 patients underwent surgical resection, with lobectomy performed in 83.6% and an R0 resection rate of 96.2%. The majority of surgical patients (74.0%) received multimodal management combining surgery with systemic therapy, which was primarily adjuvant treatment (79.6%). Among the 600 patients receiving surgery plus systemic therapy, 79.7% received adjuvant therapy alone, 10.6% received perioperative treatment, and 9.7% received neoadjuvant therapy alone; the median real-world time on treatment (rwToT) was 8.5 months, 10.1 months, and 2.1 months across these groups, respectively.

Non-surgical management increased in frequency with higher initial clinical stage. Among the 239 patients who did not undergo surgery, 78.2% received systemic therapy alone, while 21.8% received radiotherapy combined with systemic therapy. Within this chemoradiotherapy subgroup, sequential chemoradiotherapy was administered in 74.5%, concurrent chemoradiotherapy in 25.5%, and consolidation immunotherapy in 26.9%. In addition, EGFR testing was documented in 281 patients (including 185 tested during surgery), with mutations identified in 174 cases (exon 21 L858R in 47.7% and exon 19 deletion in 33.3%). The authors conclude that these data provide a reference for real-world treatment patterns during the early adoption of immunotherapy in China.