REAL-WORLD SURVIVAL OUTCOMES AND ASSOCIATED FACTORS IN RESECTED NON-SMALL CELL LUNG CANCER: INSIGHTS FROM THE NATIONWIDE FALCONS STUDY
Author(s)
Marie Wislez, Professor1, Pascal-Alexandre Thomas, Professor2, Marco Alifano, Professor3, Cyril Esnault, MSc4, Katia Thokagevistk, PhD5, Estelle Dias, MSc4, lea Emonnot, PhD4, Sarah Saget, PhD4, Vanessa PAULY, PhD2, Laurent Boyer, Professor2, Stefan Michiels, Professor6, Hervé Léna, Dr7.
1APHP, Paris, France, 2APHM, Marseille, France, 3Hôpital Cochin AP-HP, Paris, France, 4Roche SAS, Boulogne-Billancourt, France, 5Medical Evidence Strategy Expert, Roche, Boulogne-Billancourt, France, 6IGR, 94805 Villejuif cedex, France, 7CHU Rennes, Rennes, France.
1APHP, Paris, France, 2APHM, Marseille, France, 3Hôpital Cochin AP-HP, Paris, France, 4Roche SAS, Boulogne-Billancourt, France, 5Medical Evidence Strategy Expert, Roche, Boulogne-Billancourt, France, 6IGR, 94805 Villejuif cedex, France, 7CHU Rennes, Rennes, France.
OBJECTIVES: To evaluate long-term real-world disease-free survival (DFS), overall survival (OS), and associated factors among patients with resected non-small cell lung cancer (NSCLC) treated with neoadjuvant or adjuvant therapies during the pre-immunotherapy era in France.
METHODS: This retrospective study leveraged the French national thoracic surgery database (EPITHOR) enriched with clinical charts across 11 centers. Deaths were tracked via the national INSEE database linked to EPITHOR. Patients surgically resected between 2016 and 2018 were analyzed in Cohorts B1 (neoadjuvant±adjuvant) and B2 (adjuvant±neoadjuvant). Survival curves were estimated using the Kaplan-Meier method and compared with log-rank tests, with a minimum 5-year follow-up (data cutoff: December 2023).
RESULTS: A total of 555 patient charts were analyzed; disease recurrence or progression occurred in approximately two-thirds of patients across both cohorts. In the neoadjuvant cohort (B1, n=214), median OS was 62 months (5-year rate: 50%) and median DFS was 23 months (5-year rate: 37%). Clinical TNM stage (cTNM) before surgery was the sole factor significantly associated with worse OS (Stage III vs II: HR=1.39, 95% CI [1.02-1.89], p=0.027). In the adjuvant cohort (B2, n=447), median OS was 69 months (5-year rate: 54%) and median DFS was 30 months (5-year rate: 36%). For the subgroup receiving adjuvant chemotherapy only (n=265), median OS reached 86 months (5-year rate: 59%) and median DFS was 38 months. Male sex, older age, higher pathological TNM stage, and poorer ECOG score were significantly associated with worse OS. Analyzed by treatment regimen, median DFS/OS were 34.5/65, 36/73, and 18/52 months for the neoadjuvant-only, adjuvant-only, and perioperative groups, respectively.
CONCLUSIONS: Real-world OS and DFS from resected NSCLC in our study are consistent with clinical trials. Recurrence remains frequent, providing a robust baseline to benchmark the impact of expanding screening programs and emerging perioperative targeted and immunotherapies.
METHODS: This retrospective study leveraged the French national thoracic surgery database (EPITHOR) enriched with clinical charts across 11 centers. Deaths were tracked via the national INSEE database linked to EPITHOR. Patients surgically resected between 2016 and 2018 were analyzed in Cohorts B1 (neoadjuvant±adjuvant) and B2 (adjuvant±neoadjuvant). Survival curves were estimated using the Kaplan-Meier method and compared with log-rank tests, with a minimum 5-year follow-up (data cutoff: December 2023).
RESULTS: A total of 555 patient charts were analyzed; disease recurrence or progression occurred in approximately two-thirds of patients across both cohorts. In the neoadjuvant cohort (B1, n=214), median OS was 62 months (5-year rate: 50%) and median DFS was 23 months (5-year rate: 37%). Clinical TNM stage (cTNM) before surgery was the sole factor significantly associated with worse OS (Stage III vs II: HR=1.39, 95% CI [1.02-1.89], p=0.027). In the adjuvant cohort (B2, n=447), median OS was 69 months (5-year rate: 54%) and median DFS was 30 months (5-year rate: 36%). For the subgroup receiving adjuvant chemotherapy only (n=265), median OS reached 86 months (5-year rate: 59%) and median DFS was 38 months. Male sex, older age, higher pathological TNM stage, and poorer ECOG score were significantly associated with worse OS. Analyzed by treatment regimen, median DFS/OS were 34.5/65, 36/73, and 18/52 months for the neoadjuvant-only, adjuvant-only, and perioperative groups, respectively.
CONCLUSIONS: Real-world OS and DFS from resected NSCLC in our study are consistent with clinical trials. Recurrence remains frequent, providing a robust baseline to benchmark the impact of expanding screening programs and emerging perioperative targeted and immunotherapies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD17
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Oncology, Surgery