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P09.57 Estimating the Total US Incidence of Advanced/Metastatic Non-Small Cell Lung (NSCLC) Including Recurrent Disease

      Introduction

      There is increasing interest in novel therapeutic strategies for advanced and metastatic nonsmall cell lung cancer, including radical debulking. The public health impact of these strategies depends upon the incidence of both de novo and recurrent metastatic disease. The recurrent portion of this population is not well quantified because most registry data only enumerates patients at first diagnosis and staging. In this analysis, we sought to estimate the number of metastatic non-small cell lung (NSCLC) cases in the United States – both de novo and recurrent – to address this gap in knowledge.

      Methods

      SEER registry data for advanced and metastatic NSCLC de novo incidence was supplemented with three additional data sources from the GlobalData© pharmaceutical intelligence center: surveys of approximately 150 oncologists with regard to recurrent disease patterns and literature review of disease prevalence. Incidence rate was applied to population estimates to determine incident cases, then projected over time to estimate population health burden over five years.

      Results

      In 2020, the projected incident cases for stage IIIB and IV NSCLC at diagnosis is 92,152, of which 60,952 cases are non-squamous histology and 31,200 are squamous histology. We expect 24,455 non-squamous histology stages I-IIIA cases will progress to advanced disease and 6,909 squamous histology stages I-IIIA cases to progress to advanced disease. In total, there will be 85,407 stage IIIB and IV non-squamous NSCLC, including de novo (71%) and progressed cases (29%). For squamous NSCLC, we expect 38,108 total cases in stages IIIB and IV, including de novo (82%) and progressed cases (18%). The model estimates the number of combined incident and progressed cases will increase from 123,515 cases in 2020 to 134,486 cases by 2025, at an approximately 1.7% annual rate of growth.

      Conclusion

      Advanced/metastatic cases of NSCLC represent a major public health burden in the United States. De novo cases represent the majority of patients, but nonetheless progressed cases may account for approximately 20% of the total patient population in stages IIIB/IV. These estimates will help assess the potential societal impact of interventions aimed at this large patient population.

      Keywords

      NSCLC, metastatic, radiotherapy