The global median survival of people with pulmonary adenocarcinoma, the most common form of lung cancer, is progressing in France, according to the new results of the French study KBP-2020-CHG. News full of hope.
The new results of the KBP-2020-PHG study, conducted by the College of Pulmonologists of French General Hospitals in 137 establishments (Hors-CHU) published inThe New England Journal of Medicine Evidenceare encouraging.
The first is that the overall survival rate (that is, whatever the cause of death) at 3 years after a diagnosis of lung cancer rose from 16.3 % in 2000 to 38.6 % in 2020. In other words, 38.6 % of people are still alive 3 years after the diagnosis.
Global median survival has followed the same dynamic: it more than doubled in two decades (8.5 months in 2000; 20.7 months in 2020). This means that 50 % of patients were still alive 20.7 months after the start of follow -up in 2020.
One observation: the proportion of adenocarcinomas has significantly increased, representing 56.1 % of pulmonary cancers in 2020 against less than a third in 2000. There are several types lung cancer. Non -small cells bronchial cancers (more than 80 %of cases) include adenocarcinomas (60 %), epidermoid carcinomas (30 %) and, more rarely, large cell carcinomas. Much rarer, “small cell” bronchial cancers represent around 15 % of cases.
The importance of sex and the cancer stage during diagnosis
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The gap that had been found between women and men in 2000 still exists in 2020: 45.1 % of women with adenocarcinoma were alive at 3 years old, compared to 34.2 % of men. On the other hand, the share of women in people who received a diagnosis of adenocarcinoma has completely transformed: it increased from 24.5 % to 40.4 %. That of patients over 80 has also doubled.
In addition, the cancer stage at the precise moment of the diagnosis is important and conditions survival, going in 2020 by 21.3 % in patients with metastatic disease at the time of diagnosis at 84 % in those with a stage I disease (a localized form of cancer, which can easily be operated).
Progress thanks to targeted therapies
Several advances have contributed to improving management: increasing quality of imaging examinations, development of mini-invasive and robotics surgery, strengthening peri-operative strategies and more precise histological classification thanks to immunocalization. This technique makes it possible to detect, in a tumor tissue, the presence of specific proteins (using antibodies). This is to specify the type of cancer (histology) by identifying characteristic markers. Precisely, in lung cancer, it helps to differentiate the subtypes of non-small cells bronchial cancer (adenocarcinoma, epidermoid carcinoma, etc.) and directs the choice of treatment.
In addition, the introduction of molecular biology platforms has made it possible to identify target mutations specific to each tumor (EGFR, ALK, ROS1). In 2020, patients carrying these alterations and treated with targeted therapies had a three -year overall survival rate of 36 %, against 18.5 % in the absence of mutation. Among patients with metastatic disease without the molecular alterations mentioned above, the overall 3-year survival rate was 36.2 % with first-line immunotherapy against 14.3 % without immunotherapy, and the median overall survival was 21.0 months against 4.2 months.
Immunotherapy extends the survival of people in the event of metastases
In patients without molecular alterations that can be targeted by immunotherapy, first -line drugs made it possible to raise the overall survival rate at 3 years to 36.2 %, against 14.3 % without immunotherapy. Median survival increased from 4.2 to 21 months.
