Survival multiplied by two in 20 years

Lung cancer. Furthermore, the leading cause of cancer mortality worldwide, remains a major public health issue because of its high incidence and its unfavorable prognosis. For example, And this despite significant progress made by mini-invasive surgery, stereotaxic radiotherapy, targeted therapies and immunotherapy. Meanwhile,

We generally distinguish tumors with small cells and those without small cells, the latter representing 85% of tumors. Furthermore, Since 2000. Similarly, the college of pulmonologists of general hospitals in France, has conducted epidemiological studies (KBP) every ten years, which make it possible to follow the evolution of demography and to analyze the results, particularly in terms of global survival. Meanwhile, Thus, pulmonary adenocarcinoma has become the most frequently encountered histological type in France, from 29.8 % in 2000 to 46.2 % in 2010 then 56.1 % in 2020.

KBP study methodology

A collective prospectively collects all new cases of primitive lung cancer survival multiplied two 20 years seen in general hospitals. In addition, The authors of this article published in the prestigious New England Journal of Medecine reports the results observed for 2020 by comparing them to those already observed in 2000. 2010.

This database included 5667, 7051 and 8,999 patients respectively for each decade, including 50,15 cases of adenocarcinoma in 2020. The average age for diagnosis in 2020 was 67.2 years, 40.4 % of patients were women (compared to 24.5 % in 2000), and 16.9 % had never smoked. The proportion of patients aged 80 or over doubled in 20 years, from 6.4 % to 12.7 %. Additionally, The majority of patients (61.9 %) were diagnosed at a metastatic stage (stage IV), a relatively stable figure since 2010.

Major therapeutic progress related to targeted therapies

The major therapeutic progress of the last decade. including the introduction of targeted therapies (for EGFR, ALK, ROS1 mutations) and immunotherapy, have survival multiplied two 20 years significantly improved global survival (SG). In 2020, the rate of SG at 3 years for all patients with pulmonary adenocarcinoma was 38.6 %, compared to 16.3 % in 2000 and 21.2 % in 2010. The median overall survival rose from 8.5 months in 2000 to 20.7 months in 2020.

Survival varies strongly depending on the stage of diagnosis: in 2020, the 3 -year survival rate was 84.0 % for stages I, 65.9 % for stages II, 49.5 % for stages III and only 21.3 % for stadiums IV. Women. younger patients, non-smokers, with better performance index (ECOG PS 0-1) and those diagnosed at an early stage benefit from better survival.

In metastatic patients, the SG at 3 years was 36.0 % for those with molecular alteration (EGFR, ALK, ROS1) treated by targeted therapy, against 18.5 % in the absence of alteration. For the latter, the SG at 3 years was 36.2 % survival multiplied two 20 years with Immunotherapy on the front line, compared to 14.3 % without immunotherapy. The median survival went from 4.2 to 21.0 months with immunotherapy.

In conclusion. the survival of patients with pulmonary adenocarcinoma in France has improved significantly in 20 years, thanks to access to therapeutic innovations, even if the prognosis remains very linked to the stage at the time of diagnosis. This progress highlights the importance of early screening. the molecular characterization of tumors and fair access to innovative treatments for all patients.