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Metastatic Non-Small Cell Lung Cancer: Academic Treatment Settings Improve Survival

Patients with metastatic non-small cell lung cancer (NSCLC) have higher chances of surviving if they are treated in academic medical centers rather than in community-based centers, according to a new study published in the Journal of Thoracic Oncology.

Of the approximately 85% of lung cancer patients who are diagnosed with NSCLC, around 40% present with metastatic disease. Metastatic NSCLC is highly difficult to treat and leaves patients with limited chances of survival. However, new treatment strategies can help prolong life. Researchers at Duke University investigated whether NSCLC patients treated at academic centers, more likely to be on the cutting edge of research, would have improved survival rates.

An analysis of data from the National Cancer Database (NCDB) on 193,279 NSCLC patients treated between the years of 1998 and 2010 revealed a significantly higher proportion of patients achieving 2-year survival in academic centers compared with community centers, with a 2.3% difference in 1998 (11.5% vs 9.2%) increasing to a 4.3% difference by 2010 (17.4% vs 13.1%). Variations according to the type of treatment facility were particularly pronounced for adenocarcinoma, with a 2-year survival difference of 3.2% in 1998 (12.3% in academic centers vs 9.1% in community centers) increasing to a 5% difference in 2010 (20.5% vs 15.5%).

In their published paper, the authors commented on the importance of their results: "In this study we show an increasing survival difference in metastatic NSCLC between [academic centers] and [community centers] in the period from 1998 and 2010 when there was an increase in terms of both number of chemotherapy agents approved and complexity of treatment in terms of histology and molecular-based treatment strategies. With the more recent introduction of additional targeted agents and immunotherapy, additional study is needed to determine if this trend has continued. To reduce the disparity in patient outcomes, strategies to accelerate these advances in community centers may be needed."

For More Information

Ramalingam S, Dinan MA & Crawford J (2018). Survival comparison in patients with stage IV lung cancer in academic versus community centers in the United States. J Thorac Oncol. [Epub ahead of print] DOI:10.1016/j.jtho.2018.09.007

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