Article ; Online: Treatment Decision Drivers in Stage III Non-Small-Cell Lung Cancer: Outcomes of a Web-Based Survey of Oncologists in the United States.
2020 Volume 16, Issue 10, Page(s) e1232–e1242
Abstract: Purpose: We conducted a cross-sectional survey of practicing medical oncologists in the United States to obtain insight into physician and patient treatment decision making in stage III non-small-cell lung cancer (NSCLC).: Methods: A convenience ... ...
| Abstract | Purpose: We conducted a cross-sectional survey of practicing medical oncologists in the United States to obtain insight into physician and patient treatment decision making in stage III non-small-cell lung cancer (NSCLC). Methods: A convenience sample of 150 oncologists completed a 38-question Web-based survey in January 2019. Results: Surveyed oncologists (82% community based) had an average of 15 years of clinical experience and had treated an average of 20 patients newly diagnosed with stage III NSCLC in the previous 6 months. Oncologists reported presenting 55% of their patients with stage III NSCLC to tumor boards. For patients with new unresectable stage III NSCLC seen in the previous 6 months, concurrent chemoradiation therapy (cCRT) was reported as the initial treatment in an average of 48% of patients. The most frequent reason for delays in starting the initial chosen treatment was insurance preauthorization processes (reported by 65% of oncologists). A total of 55% of all patients with unresectable stage III NSCLC who received cCRT went on to receive consolidation immunotherapy; for patients who received consolidation chemotherapy after cCRT, the rate of immunotherapy was lower (42%). Biomarker test results were given as the reason for oncologists not recommending immunotherapy after cCRT in approximately a quarter of cases. The 112 oncologists with eligible patients who declined immunotherapy reported previous treatment fatigue as the reason in 34% of patients and insurance challenges in 19% of patients. Conclusion: Oncologists reported notable deviations from treatment guidelines for stage III NSCLC. Our findings highlight important opportunities to improve decision making and the coordination of care in stage III NSCLC. |
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| MeSH term(s) | Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/therapy ; Chemoradiotherapy ; Clinical Decision-Making ; Cross-Sectional Studies ; Humans ; Immunotherapy ; Internet ; Lung Neoplasms/therapy ; Neoplasm Staging ; Oncologists ; Practice Patterns, Physicians' ; Surveys and Questionnaires ; United States | |||||
| Language | English | |||||
| Publishing date | 2020-06-18 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Research Support, Non-U.S. Gov't | |||||
| ZDB-ID | 3028198-2 | |||||
| ISSN | 2688-1535 ; 2688-1527 | |||||
| ISSN (online) | 2688-1535 | |||||
| ISSN | 2688-1527 | |||||
| DOI | 10.1200/JOP.19.00781 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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