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Thoracic Cancer - 2026 - Chan - Evolving Patterns of Care Outcomes and Ongoing Challenges for Early‐Stage Non‐Small Cell1.10 MB
Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Evolving Patterns of Care, Outcomes and Ongoing Challenges for Early-Stage Non-Small Cell Lung Cancer in the Immunotherapy Era: A Queensland Population-Based Study
Thoracic Cancer, Vol.17(2), pp.1-12
2026
PMCID: PMC12897578
PMID: 41540800
Appears in Cancer Research Cluster Research Collection
Abstract
Introduction This retrospective study describes contemporary patterns of care and outcomes for early-stage non-small cell lung cancer (NSCLC) in Queensland, Australia, with a focus on immunotherapy. Methods Population-based data for patients with NSCLC diagnosed at stages I-III between 2018 and 2022 were sourced from the Queensland Oncology Repository. Follow-up on treatment and mortality was available to 31 December 2024. Poisson models were used to determine patient and clinical characteristics associated with the treatments received. Differences in five-year observed survival were calculated from multivariable flexible parametric models. Results The study cohort comprised 4608 patients. Surgery alone was the most common treatment modality for stages I and II (55% and 27%, respectively), whereas 44% of patients with stage III disease had concurrent chemoradiotherapy without surgery. Just over half (53%) of this latter group were also treated with durvalumab. First Nations people were somewhat less likely to receive either surgery (relative likelihood = 0.95, 95% CI 0.91-1.00; p = 0.04) or chemotherapy (RL = 0.95, 95% CI 0.90-0.99; p = 0.03) compared to other Queensland residents. Five-year observed survival ranged from 17% (95% CI 11%-25%) for stage IIIC to 81% (95% CI 74%-87%) for stage IA1. Patients with unresected stage III disease who received concurrent chemoradiotherapy with subsequent durvalumab were 37% less likely to die from NSCLC within 5 years of diagnosis than chemoradiotherapy alone (hazard ratio = 0.63, 95% CI 0.51-0.78; p < 0.001). Conclusions Disparities in treatment for First Nation people with NSCLC require urgent attention. Durvalumab provides a survival advantage for unresectable stage III NSCLC within a real-world setting.
Details
- Title
- Evolving Patterns of Care, Outcomes and Ongoing Challenges for Early-Stage Non-Small Cell Lung Cancer in the Immunotherapy Era: A Queensland Population-Based Study
- Authors
- Bryan A. Chan (Corresponding Author) - University of the Sunshine Coast, Queensland, Centre for BioinnovationDanny R. Youlden - Metro South HealthAndrew Pattison - Sunshine Coast University HospitalTracey Guan - Metro South HealthDanica Cossio - Metro South HealthJasotha Sanmugarajah - Gold Coast Hospital
- Publication details
- Thoracic Cancer, Vol.17(2), pp.1-12
- Publisher
- John Wiley & Sons, Inc.
- Date published
- 2026
- DOI
- 10.1111/1759-7714.70185
- ISSN
- 1759-7714; 1759-7706
- PMID
- 41540800; PMC12897578
- Copyright note
- © 2026 The Author(s). Thoracic Cancer published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
- Data Availability
- The unit record data used in this study are not publicly available to protect patient privacy and confidentiality. Deidentified data may be available from the corresponding author on reasonable request.
- Grant note
- AstraZeneca Australia
- Organisation Unit
- School of Health; Cancer Research Cluster; Centre for Bioinnovation
- Language
- English
- Record Identifier
- 991206279702621
- Output Type
- Journal article
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