How Much Has Immunotherapy Increased Survival in Stage 4 Lung Cancer?

Stage 4 non-small cell lung cancer (NSCLC) survival has improved since the first immunotherapy drug became available for these patients in the United States in 2015. According to a recent study by Wang and colleagues published in Cancer on 10 July 2024, NSCLC accounts for 90% of all lung cancer cases and is the leading cause of cancer-related deaths in both men and women in the United States.

Outcomes in 190 Thousand Patients

In this real-world study, researchers used the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, which collects cancer data covering approximately 48% of the US population. They compared survival among 100,995 metastatic NSCLC patients treated between 2015 and 2020, after immunotherapy became standard treatment, with 90,807 patients treated in the pre-immunotherapy period of 2010-2014.

Chart: Survival Before and After Immunotherapy in Patients with Stage 4 NSCLC

Patients treated in the immunotherapy era had a lower risk of cancer death than those treated beforehand. Cancer-specific survival at 1, 3, and 5 years was 44% versus 36.8%, 21.7% versus 14.4%, and 14.3% versus 9%, respectively. Median survival was 10 months in the immunotherapy era versus 8 months beforehand.

The researchers reported that survival remained significantly higher in the immunotherapy era even after adjusting for age, sex, race, income, and geographical region.

Commentary

Using a large national database to demonstrate immunotherapy’s positive effects on lung cancer patients, this study provides strong real-world evidence supporting these findings.

Immunotherapy offers long-term benefits to a particular patient group. To extend these benefits to more patients, future research should focus on developing new agents that can improve its effectiveness.

The study shows how immunotherapy has improved NSCLC survival and highlights the steps needed to make this treatment accessible to a broader population.