Real-world outcomes of first-line treatments in patients with metastatic non-small cell lung cancer: Final analysis of the Registurk-Lung registry.

Abstract

e20633 Background: Real-world data are critical to understanding treatment patterns and outcomes in metastatic non–small cell lung cancer (mNSCLC) outside clinical trials. The REGISTURK-LUNG registry was designed to evaluate demographic, clinicopathological characteristics, treatment strategies, and survival outcomes of patients with mNSCLC treated in routine clinical practice in Turkiye. Methods: REGISTURK-LUNG is a multicenter, observational registry conducted across 41 centers. This final analysis includes 5,293 patients diagnosed with stage IV NSCLC between January 2022 and March 2024. Demographic features, histopathology, biomarker testing, first-line treatment patterns, progression-free survival (PFS), overall survival (OS), and response rates were analyzed. Survival outcomes were estimated using the Kaplan–Meier method and compared using log-rank tests. Hazard ratios (HRs) were calculated where applicable. Results: The median age was 68 years (range 29–94), and 84.1% of patients were male. Adenocarcinoma (52.8%) and squamous cell carcinoma (32.9%) were the most common histologies. PD-L1 testing was performed in 22.1% of patients. First-line treatment consisted of chemotherapy alone in 88.2%, immunotherapy-containing regimens in 11.8% (single-agent immunotherapy 2.4%; chemo-immunotherapy 9.4%). Median PFS was significantly longer in patients receiving immunotherapy-containing regimens compared with chemotherapy alone (7.5 vs 5.0 months; HR 0.73, 95% CI 0.59–0.91; p = 0.004). Median OS was also improved with immunotherapy-containing treatments (16.0 vs 13.6 months; HR 0.64, 95% CI 0.53–0.88; p < 0.001). Worse PFS and OS were observed in patients with multiple metastatic sites, brain or liver metastases, and poorer ECOG performance status. Higher PD-L1 expression was associated with improved OS (p = 0.001). Conclusions: In this large real-world registry of patients with metastatic NSCLC, first-line immunotherapy-containing regimens were associated with significantly improved PFS and OS compared with chemotherapy alone. These findings support the effectiveness of immunotherapy in routine clinical practice and highlight the prognostic impact of metastatic burden, performance status, and biomarker status in mNSCLC.