Impact of guideline concordance on survival in non-small cell lung cancer: multicenter retrospective cohort study

A multicenter retrospective cohort study in Germany used insurance claims data to determine impact of guideline-concordant care on real-world survival among patients with non-small cell lung cancer. Claims data were collected of 8,261 individuals diagnosed with NSCLC between 2019 and 2021: 889 early-stage patients (group 1) and 1,618 advanced-stage patients (group 2). In group 1, only 547 (61.5%) received adequate diagnostic imaging (FDG-PET/CT or scintigraphy with CT/MRI) within 42 days before surgery. These patients had longer overall survival compared to patients with inadequate imaging (HR 0.71; p=0.003); additionally, a survival advantage was ovbserved for FDG-PET/CT over scintigraphy with CT/MRI (HR 0.58; p=0.016). In group 2, patients received less biomarker testing outside the National Network Genomic Medicine Lung Cancer program (nNGM). Biomarker testing is a prerequisite for targeted therapy, which was associated with longer overall survival compared to non-targeted therapies (HR 0.54; p<0.001). The authors conclude that real-world evidence showed that guideline-concordant NSCLC care was more frequent in specialized settings, resulting in improved overall survival.