Lung cancer is one of the most common malignancies, characterized by high mortality and late detection.

OBJECTIVE

To determine the main treatment strategies for patients with stage III—IV non-small cell lung cancer (NSCLC), conduct an independent assessment of the effectiveness of diagnostic measures used in routine practice, and evaluate the effectiveness of various treatment tactics.

MATERIAL AND METHODS

The prospective observational study included 29 clinical centers from various regions of Russia, with 514 medical records of NSCLC stage III—IV patients processed and analyzed. The median age of patients was 59 years. Stage III was diagnosed in 58% of patients, and stage IV in 42%. The main histological subtypes were adenocarcinoma in 47.4% of cases and squamous cell carcinoma in 41.9%. PD-L1 expression was identified in 226 (44%) patients: PD-L1 less than 1% was detected in 57% of cases, PD-L1 1—49% in 32%, PD-L1 50—100% in 25%. Various genetic abnormalities were found in 12.5% of patients: EGFR gene mutation in 19%, ALK translocation in 5%, ROS1 in 1%, BRAF V600E and KRAS mutations in 1.4%.

RESULTS

Chemoradiotherapy was performed in 153 (29.8%) patients with inoperable stage III NSCLC. 361 patients received first-line antitumor drug therapy. Chemotherapy was administered to 333 patients, with combined platinum-containing chemotherapy in 70% of cases. Immunooncological drugs in the first line were prescribed for 156 patients (monotherapy 15.9%, combined chemoimmunotherapy 73.1%, dual immunotherapy 11%). The objective response of the first line was 32.78%. Targeted therapy was administered in the first line to 25 patients. At the time of data analysis, 145 (40%) patients received second-line drug therapy.

CONCLUSION

The obtained results provide a general overview of the epidemiology, diagnostic features, and treatment of locally advanced and disseminated NSCLC in Russia