Physiological differences between male and female patients have significant effects on disease management and treatment outcomes. In a paper presented at the 2019 ASCO Annual Meeting, researchers evaluated the prognostic value of sex in the management of non-small cell lung cancer (NSCLC) using clinical data.
Information regarding patients with stage IV NSCLC from Hospital Puerta de Hierro (HPH) was obtained from electronic health records using Big Data Analytics (n = 387). Further data was provided from the Spanish Lung Cancer Group (GECP) Tumor Registry (n = 1382) and published research from the cBioPortal (MSK; n = 601).
The researchers estimated survival curves using Kaplan-Meier analysis, and the prognostic factor of sex was assessed through the Cox proportional hazards regression model.
The researchers found that the median overall survival (OS) was 12 months for men and 19 months for women (P<0.001). Women with stage IV NSCLC harboring an EGFR sensitizing mutation were found to outlive men as well, with men and women having median OS’ of 19 and 32 months, respectively.
After using Cox regression to adjust for other possible confounding variables, this sex effect was still significant. Adjusted hazard ratios (HRs) for sex were 0.65 (95% confidence interval [CI], 0.51-0.83), 0.84 (95% CI, 0.66-1.1), and 0.76 (95% CI, 0.65-0.88) for HPH, MSK, and GECP datasets, respectively.
Consistent with these results were the EGFR-positive population adjusted HRs for sex, being 0.53 (95% CI, 0.25-1.1), 0.59 (95% CI, 0.35-0.98), and 0.60 (95% CI, 0.45-0.86) for HPH, MSK, and GECP datasets, respectively.
The team said this analysis confirmed previous findings of women living almost twice as long as their male counterparts with stage IV NSCLC. This trend remained true after adjusting for various factors, “highlighting the fact that survival rates estimations, which are usually performed grouping men and women together, might not be accurate enough for prognosis assessments,” the researchers concluded.
Barquin M, Garcia-Garcia F, Romero A, et al. Sex is a strong prognostic factor for overall survival in advanced non small cell lung cancer patients and should be considered for survival rates estimations. Abstract # e20580. Presented at the 2019 ASCO Annual Meeting, Chicago, IL, May 31-June 4, 2019.