Background
Lung cancer is the leading cause of cancer-related death both globally and in Australia1, with non-small cell lung cancer (NSCLC) being the most prevalent form, often diagnosed at advanced stages2. Clinical trials have demonstrated that first-line immunotherapy significantly improves survival in NSCLC patients without actionable driver mutations. However, real-world data on outcomes, particularly within regional New South Wales (NSW), are scarce. Mortality rates and survival outcomes are generally poorer in rural Australia compared to metropolitan areas. This study assessed the survival outcomes of patients with advanced NSCLC treated with first-line immunotherapy at Dubbo Health Service and compared them to existing clinical trial data.
Aims
This study aims to evaluate the effectiveness of first-line immunotherapy on overall survival (OS) and progression-free survival (PFS) in advanced NSCLC patients treated at Dubbo Health Service.
Methods
All patients with advanced NSCLC reviewed at Dubbo Health Service by medical oncologist Dr Rajat Rai from January 1, 2019, to December 31, 2023, and treated with first-line immunotherapy were included in our survival analyses. Patients with targetable driver mutations were excluded.
Results
This study included 54 patients, with an equal distribution of females and males. The median OS was 12.1 months (95% CI 10.7 – 13.5), with a 12-month OS rate was 54% and 5-year OS rate of 25%. Median PFS was 5.6 months (95% CI 4.0 – 7.1). No significant correlation between OS and PD-L1 status was found. Lower SEIFA scores were associated with decreased survival.
Conclusion
Real-world survival outcomes at Dubbo Health Service were inferior to clinical trial data, however 3 and 5-year survival rates were comparable. This research underscores the well-documented disparities in rural healthcare outcomes and emphasises the need for targeted interventions to improve survival rates for patients in regional and rural NSW.