Stigma May Exacerbate Disproportionately Low Guideline-Concordant Treatment Rates for Patients With Advanced-Stage Lung Cancer in the United States.
Stigma May Exacerbate Disproportionately Low Guideline-Concordant Treatment Rates for Patients With Advanced-Stage Lung Cancer in the United States.
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DOI：
10.1016/j.jtocrr.2022.100302
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发表时间：
2022-04
影响因子：
--
通讯作者：
David EA
中科院分区：
文献类型：
--
作者：
Peng T;Hamann HA;David EA
近年来，晚期NSCLC患者的治疗方式的收集以相当快的速度发展。EGFR酪氨酸激酶抑制剂和免疫检查点抑制剂，如程序性死亡配体1抑制剂，已经深刻地改变了治疗，并重新定义了III至IV期NSCLC患者的可能性。1，2反过来，指南建议在适应这种不断变化的治疗环境方面一直是动态的。总之，这些进展伴随着治疗提供者的乐观态度发生了前所未有的转变; Rigney等人3最近的一项调查发现，67%的肿瘤学家报告晚期NSCLC患者有足够的治疗选择，而10年前只有36%。尽管这些治疗选择和专业热情不断扩大，但实际治疗率揭示了建议与现实之间的差距。来自国家癌症数据库（NCDB）的分析显示，1998年至2012年期间被诊断患有晚期NSCLC的患者比例实际上随着时间的推移而增加。4此外，晚期NSCLC患者接受指南一致性治疗的频率低于其他癌症患者。4-10 Fang等人6使用监测、流行病学和最终结果（SEER）数据库发现，2006年至2011年期间，41%诊断为III期NSCLC的非西班牙裔白色和黑人患者接受了指南一致性化疗。6对于IV期NSCLC，1998年至2012年期间NCDB中约50%的患者接受了指南推荐的治疗。4相比之下，60%的患者诊断为
In recent years, the collection of treatment modalities for patients with advanced-stage NSCLC has evolved at a considerable rate. EGFR tyrosine kinase inhibitors and immune checkpoint inhibitors, such as programmed death-ligand 1 inhibitors, have profoundly transformed therapy and redefined what is possible for patients with stages III to IV NSCLC. 1, 2 In turn, guideline recommendations have been dynamic in adapting to this everchanging treatment landscape. Together, these advances have been accompanied by an unprecedented shift in optimism among treatment providers; a recent survey by Rigney et al. 3 found that 67% of oncologists reported adequate treatment options for patients with advanced-stage NSCLC, compared with only 36% just 10 years prior.Despite these expanding treatment options and professional enthusiasm, actual treatment rates reveal the chasm between recommendations and reality. Analyses from the National Cancer Database (NCDB) revealed that the proportion of patients diagnosed with having advanced-stage NSCLC between 1998 and 2012 receiving no treatment actually increased over time. 4 Furthermore, patients with advanced-stage NSCLC tend to undergo guideline-concordant treatment less frequently than patients with other cancers. 4–10 Using the Surveillance, Epidemiology, and End Results (SEER) database, Fang et al. 6 found that 41% of non-Hispanic white and black patients diagnosed with having stage III NSCLC from 2006 to 2011 received guidelineconcordant chemotherapy. 6 For stage IV NSCLC, approximately 50% of patients in the NCDB between 1998 and 2012 received guideline-recommended treatment. 4 By comparison, 60% of patients diagnosed with
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