WCLC 2018: Survival Benefit in Women Compared With Men
Posted: Thursday, October 4, 2018
In the first prospective trial of its scope, a SWOG-sponsored study has revealed that women with non–small cell lung cancer (NSCLC) have significantly better overall survival rates than men, regardless of smoking history or any other factor. The research, funded by the National Institutes of Health, was presented at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto (Abstract OA06.01).
“Women with NSCLC live longer, even when we control for every factor that might influence survival in NSCLC, including tobacco and other exposures, lifestyle factors, disease stage, treatment, tumor biology and hormonal factors,” stated lead investigator Kathy Albain, MD, of Loyola University Stritch School of Medicine, Chicago, in an IASLC press release.
The intergroup study enrolled 981 patients with newly diagnosed stages I to III NSCLC into 4 cohorts: female ever-smokers (n = 337), female never-smokers (n = 188), male ever-smokers (n = 383) and male never-smokers (n = 49). Participants were followed for 5 year, or until their deaths, to determine overall survival.
The 5-year overall survival estimates were significantly better for both female cohorts: female never-smokers, 73%; female ever-smokers, 69%; male never-smokers, 58%; and male ever-smokers, 52%. After the investigators adjusted for variables that existed among the cohorts, overall survival remained “markedly improved” for women. A multivariate overall survival model of all cohorts revealed significantly better overall survival for women and higher body mass index, whereas stage II and III disease and older age predicted worse survival.
“Despite adjustments, favorable female survival could not be explained away,” concluded the investigators. “Randomized studies should stratify by sex, and validation analyses should be conducted in targeted therapy and immunotherapy trials.”
