Introduction: This study aims to document patient characteristics, treatment modalities, and survival outcomes of patients with lung cancer in Vietnam from 2018 to 2024. Methods: This was a retrospective study of patients with lung cancer treated at Nghe An Oncology Hospital over a 6-year period (2018–2024). The primary endpoints included lung cancer treatment methods for non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) and overall survival (OS). Secondary endpoints involved factors related to survival duration. Results: A total of 3548 patients were included: 3087 with NSCLC (87%) and 419 with SCLC (11.8%) (median age 64 years, range 18–97 years; 3:1 male-to-female ratio). Adenocarcinoma (AC) was the predominant histologic subtype (67%), followed by squamous cell carcinoma (SCC) (13.4%). EGFR mutation was detected in 43.2% of cases. From 2018 to 2024, the proportion of early-stage lung cancer diagnoses (stages I and II) increased from 2.7% to 9%, and the detection rate of advanced or metastatic stages (stages III and IV) decreased. Surgery was the primary treatment for localized NSCLC (62.5%), and stage III cases predominantly received radiation and chemotherapy (40.8%), including 38.6% with concurrent chemoradiotherapy. In stage IV NSCLC, chemotherapy was the most common treatment (53.9%), followed by targeted therapy (25.2%) and immunotherapy (1.9%). SCLC was mostly diagnosed at the extensive stage (68.0%), with chemotherapy being the mainstay of treatment (73.0%), followed by chemoradiotherapy (12.9%) and palliative care (13.1%). Median OS was 15.3 months (95% CI, 14.5–16.1), with a 5-year survival rate of 14.2%. Median OS for NSCLC cases was 16.4 months (95% CI, 15.4–17.4), with 5-year survival rates of 55.2%, 47.6%, 20.2%, and 8.3% for stages I, II, III, and IV, respectively. Median OS for SCLC cases was 11.0 months (95% CI, 9.7–12.4), with a 5-year survival rate of 4.7%. Independent prognostic factors for mortality included male sex, poor performance status (PS ≥ 2), small cell histology, metastatic disease, brain metastases, and initial nonsurgical treatment. Conclusion: This study provides critical data on the epidemiology and prognosis of lung cancer in Vietnam, highlighting the role of personalized treatment approaches in improving clinical outcomes. These findings underscore the urgent need for integrated public health strategies to enhance early detection and access to advanced therapies, thereby reducing the lung cancer burden in Vietnam.

Introduction: Lung cancer has been one of the most prevalent cancers worldwide in recent decades. According to the findings of the KEYNOTE-407 (2018) study on patients with stage IV squamous cell lung cancer, the combination of pembrolizumab and chemotherapy in the first-line treatment prolongs overall survival compared with chemotherapy alone. This study aimed to evaluate the efficacy and side effects of treating patients with stage IV non–small cell lung cancer with pembrolizumab in combination with platinum-based doublet chemotherapy. Methods: A retrospective multicenter study on 46 patients at four hospitals in Vietnam between June 2018 and August 2022. Patients received first-line treatment with a protocol of pembrolizumab in combination with platinum-based doublet chemotherapy (pemetrexed plus carboplatin or paclitaxel plus carboplatin). The study's primary endpoints were progression-free survival and safety. The secondary endpoint was overall survival. Results: The median progression-free survival was 11.0 months (95% CI, 7.4–14.7 months). The median overall survival was 23.1 months (95% CI, 18.4–27.8 months). The survival rate of patients after 1 and 2 years was 82.3% and 43.3%, respectively. The most common side effects were anemia and elevated liver enzymes, but they were primarily mild or moderate severity. Progression-free survival did not depend on cancer type based on histology (p = 0.13). The progression-free survival was independent of programmed death ligand-1 expression levels < 50% or ≥ 50% (p = 0.68). Conclusion: Treatment of stage IV non–small cell lung cancer without EGFR and ALK gene mutations with the immunotherapy protocol of pembrolizumab in combination with platinum-based doublet chemotherapy resulted in favorable outcomes without any new safety concerns. A larger sample size and longer follow-up in the future are necessary to yield more complete results.

Background: This study aimed to evaluate the effectiveness and safety of first-line pembrolizumab monotherapy in patients with advanced non-small cell lung cancer (NSCLC) in real-world clinical practice in Vietnam. Methods: We performed a multicenter retrospective cohort study of patients with locally advanced or metastatic NSCLC who received first-line pembrolizumab monotherapy in Vietnam between January 2018 and August 2024. The primary endpoints were progression-free survival (PFS), overall survival (OS), and safety profile. Results: A total of 73 patients were included, with a median age of 69 years (range, 47–92). Most patients had good performance status (ECOG PS 0–1, 75.3%) and high PD-L1 expression (TPS ≥ 50%, 86.3%). The overall response rate was 60.3%, and the disease control rate was 79.5%. Median PFS was 11.3 months (95% CI, 6.9–15.8), and median OS was 25.4 months (95% CI, 20.8–30.0). Multivariate analysis identified never-smoking status (HR 3.14, 95% CI 1.16–8.50; p = 0.024), squamous histology (HR 4.09, 95% CI 1.18–14.17; p = 0.026), and low PD-L1 expression (TPS 1–49%) (HR 3.67, 95% CI 1.14–11.78; p = 0.029) as independent predictors of inferior overall survival. Immune-related adverse events, including pneumonitis, hepatitis, nephritis, fever, skin reactions, and myositis, were mostly mild and manageable, with grade 3 toxicity occurring in only 4.2% of patients. Better survival was observed in patients with high PD-L1 expression and non-squamous histology. However, the association with non-squamous histology should be interpreted with caution due to the very small number of squamous cases. Conclusions: First-line pembrolizumab monotherapy demonstrated favorable effectiveness and acceptable safety in patients with advanced NSCLC in real-world clinical practice in Vietnam. Clinical outcomes were particularly favorable in patients with high PD-L1 expression, non-squamous histology, and a history of smoking. Nevertheless, the survival benefit associated with non-squamous histology should be interpreted cautiously, given the limited number of patients with squamous histology. These findings support the use of pembrolizumab monotherapy in selected patient populations within resource-limited settings.

Aims: The study aimed to evaluate the effectiveness and adverse events of tyrosine kinase inhibitors (TKIs) in the first-line treatment of advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EG... | Find, read and cite all the research you need on Tech Science Press

Evidence describing temporal changes in disease stage, molecular testing, treatment patterns, and survival outcomes in non–small cell lung cancer (NS

Objective: Patients with stage III non-small cell lung cancer (NSCLC) present with a heterogeneous disease profile and often require multifaceted treatment strategies. This research aimed to investigate the demographic features, therapeutic patterns, and survival outcomes of such patients in Vietnam. Methods: A retrospective descriptive study was conducted on 731 patients diagnosed with stage III NSCLC American Joint Committee on Cancer (AJCC) 8th edition, at Nghe An Oncology Hospital from January 2018 to August 2024. Descriptive statistics summarized baseline and treatment characteristics. We calculated progression-free survival (PFS) and overall survival (OS) through the Kaplan–Meier approach and compared survival curves with the log-rank test. Prognostic variables were assessed using Cox regression analysis. Results: Patients had a median age of 64 years, and the majority (84%) were male. Disease stages IIIA, IIIB, and IIIC accounted for 26.0%, 49.9%, and 24.1% of cases, respectively. Adenocarcinoma (60.7%) was the most common histological subtype. Initial treatments included surgery (8.5%), concurrent chemoradiotherapy (38.6%), sequential chemoradiotherapy (2.2%), radiotherapy alone (1.4%), systemic therapy (37.3%), and palliative care (12.0%). From 2018 to 2024, the use of systemic therapy declined (88.5% to 21.7%), while concurrent chemoradiotherapy rose significantly (1.1% to 51.5%). Median progression-free survival (mPFS) and median overall survival (mOS) were 8.9 months and 20.5 months, respectively. Patients with stage IIIA had significantly better outcomes (mPFS: 12.6 months; mOS: 32.4 months; p < 0.001). Surgical treatment yielded the longest survival (mPFS: 13.5 months; mOS: 42.8 months). Favorable prognostic factors included adenocarcinoma subtype, presence of driver mutations, stage IIIA, and good performance status. Conclusion: For stage III NSCLC, concurrent chemoradiotherapy is still considered the standard treatment, whereas surgery can provide the highest survival advantage in carefully selected cases. Histology, molecular profile, and disease stage are key prognostic indicators.