Aims
To review current treatment trends in systemic therapy and examine outcomes for patients diagnosed with NSCLC. At risk patient populations, specifically, First Nations peoples, and those residing in rural and regional locations will be assessed against the state-wide population to highlight variances and opportunities for improvement in care.
Methods
Data were extracted from Qld Oncology Repository (QOR), a comprehensive repository which contains demographic, diagnosis, and treatment data on Queenslanders diagnosed with cancer. The study cohort includes patients diagnosed with stage I-IV NSCLC in 2011-2019.
Results
Optimal care pathways for lung cancer state that NSCLC patients receiving resection may also be candidates for neoadjuvant and adjuvant systemic therapy. The rate of neoadjuvant treatment for Non-First Nations peoples was 4%, and 2% for First Nations peoples. Similarly, the adjuvant systemic therapy rate for Non-First Nations peoples was 23% and 17% for First Nations peoples. Disparities in adjuvant treatment rates were also observed across residential location. For example, rates for patients living in a Major City was 25% but for those living in inner regional, outer regional and remote or very remote areas, was 23%, 17%, and 16%, respectively. Mortality rates have decreased significantly, likely due to earlier screening programs and advancements in treatment therapies such as targeted and immunotherapies. However, variations in two-year survival rates remain significant across stage (stage I, 85%, stage II, 65%, stage III, 45% and stage IV, 18%).
Conclusion
The vast and readily available cancer data through QOR has allowed for an in-depth analysis of treatment trends for at risk populations and an examination of survival outcomes for Queenslanders diagnosed with NSCLC. This analysis not only provides a foundation for quality improvement initiatives but also for ongoing reporting to ensure inequity in care provision is monitored and measured for all Queenslanders diagnosed with NSCLC.