Characteristics, management, and healthcare resources of patients with advanced non–small-cell lung cancer surviving 5 years after nivolumab treatment initiation: A national database analysis - Centre de recherche des Cordeliers
Journal Articles Respiratory Medicine and Research Year : 2023

Characteristics, management, and healthcare resources of patients with advanced non–small-cell lung cancer surviving 5 years after nivolumab treatment initiation: A national database analysis

Valentine Grumberg
  • Function : Author
Dorothée Reynaud
  • Function : Author
Anne Françoise Gaudin
  • Function : Author
Alexandre Batisse
  • Function : Author
Ronan Jolivel
  • Function : Author
Baptiste Jouaneton
  • Function : Author
François-Emery Emery Cotté
  • Function : Author
Christos Chouaïd
  • Function : Author

Abstract

Background: Data on long-term survivors with advanced non-small-cell lung cancer (NSCLC) treated with nivolumab are available from randomized trials. Characteristics, management, and healthcare resources of those patients need to be confirmed with real-world data. Methods: The UNIVOC retrospective observational study included all patients with advanced NSCLC recorded in the French national hospital database starting nivolumab in 2015 and followed them until December 2020. The Kaplan-Meier method estimated the overall survival (OS). A machine learning approach identified patients with similar treatment sequences. Results: Within the 3,050 patients who had nivolumab initiation,5-year OS rate was 14.6 % (95 %CI 13.3 %–16.2 %). In total, data covering at least 5 years of follow-up were retrieved for 231 surviving patients. Survivors were younger, often female and had fewer comorbidities than non-survivors. Three clusters of patients with different nivolumab treatment durations were identified: 1/ Continuous nivolumab treatment; 2/ Long period of nivolumab treatment followed by chemotherapy or no treatment; 3/ Short period of nivolumab treatment then chemotherapy or no treatment. At 5 years, 61.0 % of survivors were no longer receiving systemic therapy, 26.4 % were treated with nivolumab, 8.7 % chemotherapy, and 3.9 % other immunotherapies. Among 5-y survivor patients, the average number of hospitalisations per patient decreased from 23.4 to 12.8 between the 1st and the 5th year. In the 5th year, 46 % of patients had no more hospitalization for lung cancer. Conclusions: This large nationwide study confirms the long-term benefit of nivolumab treatment for advanced NSCLC patients in the real-world setting, with a 5-year survival rate similar to that reported in clinical trials.
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hal-04271269 , version 1 (10-11-2023)

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Jean Baptiste Assié, Valentine Grumberg, Dorothée Reynaud, Anne Françoise Gaudin, Alexandre Batisse, et al.. Characteristics, management, and healthcare resources of patients with advanced non–small-cell lung cancer surviving 5 years after nivolumab treatment initiation: A national database analysis. Respiratory Medicine and Research, 2023, 84, ⟨10.1016/j.resmer.2023.101051⟩. ⟨hal-04271269⟩
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