(020) Gender differences in anticancer drugs among patients with Non-Small Cell Lung Cancer in Taiwan

Publication Number: 684

Background: Lung cancer is the most common cause of cancer-related deaths in Taiwan. The first-line drug therapy options for non-small cell lung cancer (NSCLC) include chemotherapy, EGFR tyrosine kinase inhibitor (EGFR TKI), and ALK inhibitor. Although reports have revealed that men have a poorer prognosis for NSCLC compared to women, there have been no studies that have included all the known prognostic factors to evaluate survival in different genders.

Objectives: To analyze the gender differences in prescribing patterns and survival outcomes among advanced NSCLC patients in Taiwan.

Methods: In this retrospective cohort study, we included individuals enrolled in Taiwan's Cancer Registry from 2012 to 2019 who were newly diagnosed with stage 3a, 3b, or 4 NSCLC and received chemotherapy, EGFR TKI, or ALK inhibitor during the study period. All patients were followed up for at least one year. We collected patient characteristics, tumor-related factors, treatment-related factors, and other factors. Continuous variables were presented as mean and standard deviation or median and quartiles, while categorical variables were presented as counts and percentages. For survival outcomes, we calculated the hazard ratio (HR) to estimate survival differences between genders. The difference was estimated using p-value, with <0.05 considered statistically significant.

Results: We identified 16255 eligible patients (8102 men, 8153 women). Men were more likely to have smoking, drinking, radiotherapy, and squamous histology. Women were more likely to have adenocarcinoma histology. The median first prescription time was 34 days for men and 35 days for women. The first prescription types were chemotherapy (58.3 % for men vs. 33.1 % for women), EGFR TKI (40.5 % for men vs. 65.3 % for women), and ALK inhibitor (1.3 % for men vs. 1.6 % for women). The median overall survival was significantly shorter with men than women (12.43 months vs. 20.43 months; adjusted HR; 1.23; 95% confidence interval [CI], 1.17 to 1.29; p<0.0001).

Conclusions: Women had significantly longer overall survival than men in patients with advanced NSCLC. Further study is required to understand the cause of survival differences between men and women to provide adequate care to patients of either gender.