Impact of Lack of Access to Immunotherapy on Survival in Stage IV Non–Small Cell Lung Cancer: A Multicenter Retrospective Study From Lebanon
Rattachement africain : lb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
PURPOSE Lung cancer remains the leading cause of cancer-related mortality worldwide. Immune checkpoint inhibitors (ICIs) have become the standard of care for stage IV non–small cell lung cancer (NSCLC). In 2021, Lebanon experienced a severe economic collapse that resulted in major shortages of immunotherapy and treatment interruptions. The aim of this study was to explore the potential impact of immunotherapy shortage on progression-free survival (PFS). METHODS This retrospective multicenter study included patients with newly diagnosed stage IV NSCLC treated between January 2019 and December 2020 (control group) and between October 2021 and December 2022 (crisis group). The primary end point was PFS, defined from treatment initiation to progression according to RECIST 1.1 criteria or death. Kaplan-Meier survival curves were generated, and differences were assessed using log-rank test. RESULTS A total of 500 medical records were reviewed; 158 eligible patients were included (73 control, 85 crisis). The total cohort included 60.8% men with a mean age of 69.7 years. Among immunotherapy recipients, 44.0% received full-dose therapy (dose density ratio = 1.0), 41.4% received 50%-99% of standard dose (dose density ratio = 0.50-0.99), and 14.7% received <50% (dose density ratio = <0.50). The median PFS was 6.33, 12.86, and 10.23 months, respectively; no statistically significant difference was observed ( P = .132). CONCLUSION Despite a statistically significant reduction in immunotherapy dose density during the economic crisis, no statistically significant difference in PFS was detected between the precrisis and crisis groups. These findings suggest that reduced immunotherapy dosing may not be associated with inferior short-term survival outcomes in stage IV NSCLC, although the study was not designed or powered to establish equivalence.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of Lack of Access to Immunotherapy on Survival in Stage IV Non–Small Cell Lung Cancer: A Multicenter Retrospective Study From Lebanon
- Date Crossref
- 01/07/2026
- Éditeur
- American Society of Clinical Oncology (ASCO)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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American University of Beirut Medical Center Naef K. Basile Cancer Institute pays non établi dans la noticeÉtablissement de santé
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Lebanese American University Division of Hematology and Oncology pays non établi dans la noticeUniversité ou école supérieure
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Saint George Hospital pays non établi dans la noticeÉtablissement de santé
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Saint Joseph University Division of Hematology and Oncology pays non établi dans la noticeUniversité ou école supérieure
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Hammoud Hospital University Medical Center Division of Hematology and Oncology pays non établi dans la noticeÉtablissement de santé
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Saint Georges University Medical Center Division of Hematology and Oncology pays non établi dans la noticeUniversité ou école supérieure
Naef K. Basile Cancer Institute — American University of Beirut Medical Center, Division of Hematology and Oncology — Lebanese American University et Saint George Hospital, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.