Real-World Evidence in Lung Cancer

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Background

Lung cancer is a deadly malignant disease that has the highest morbidity and mortality in China. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer (80–85%), and approximately 57% of patients who have NSCLC already had distant metastases when their diagnosis was confirmed. In 2015, there were 733,300 new cases of lung cancer in China and 610,200 lung cancer-related deaths in total. The morbidity of lung cancer has continued to rise in recent years. For patients with advanced non-small cell lung cancer, systemic therapy based on histological subtype was the main treatment method, and first-line treatment was platinum-containing dual-drug chemotherapy. With the identification of lung cancer driver genes such as EGFR, ALK, ROS1, BRAF, molecular targeted therapy has further prolonged progression-free survival and overall survival of patients and has become a first-line treatment option for populations with therapy-sensitive mutations whereas for not driven NSCLKC the immune checkpoint inhibitors (ICIs) have established a new standard of care either alone or in combination with chemotherapy.

While randomized clinical trials provide the highest level of scientific evidence for advancing patient care, they leave large gaps in our collective understanding. Prospective studies include a fairly homogeneous and often idealized patient population which may represent only a fraction of the patients seen in a typical clinic. As a result, there is a relative lack of data regarding patients ineligible for these trials (due to comorbidities, performance status or high-risk clinical situations) and for patients who are often not represented in large studies (such as those with socioeconomic, cultural or geographic barriers to trial enrollment). Real-world evidence can be a powerful complement to these trial data and help to better inform clinical decision-making.

This Research Topic will draw attention to valuable real-world evidence highlighting the disease and patient characteristics, therapeutic outcomes (efficacy and safety) and treatment patterns in thoracic oncology. These data would typically be drawn from registries, medical records and patient databases and not prospective clinical trials. Clinical outcomes with standard therapy from underrepresented geographic regions are of great interest. Practice patterns and notable institutional experiences are also welcome. This collection will include Original Research, Review, and Case Report articles - other submissions will also be reviewed if appropriate.

Manuscripts should focus on but are not limited to:

1) Real-world data about ICIs outcome and safety in an elderly or unfit population
2) Real-world data about ICIs outcome and safety about ICIs outcome and safety in NSCLC patients with brain metastasis
3) Real-world data about TKIs outcome and safety in NSCLC patients with brain metastasis
4) Real-world data about TKIs outcome and safety in an elderly or unfit population
5) Real-world data about value and utility of PRO and PROM

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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