{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:38:35Z","timestamp":1789033115308,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T00:00:00Z","timestamp":1429228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>New therapies for metastatic non\u2013small cell lung cancer (NSCLC) have improved survival in clinical trials. However, only a minority of patients receive systemic therapy. This article reports treatment patterns and outcomes for a population of Canadian patients with metastatic NSCLC (Ontario).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients diagnosed with stage IV NSCLC from 2005 to 2009 were identified through multiple linked provincial databases. Patient demographics, systemic treatment, and survival were examined over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Metastatic NSCLC patients (n\u2009=\u20098113) were identified. The median age was 68 years; 39% had adenocarcinoma, 14% had squamous carcinoma, and a higher than expected proportion (43%) had NSCLC not otherwise specified. Only 24% the patients received first\u2010line chemotherapy; only 31% of these received second\u2010line chemotherapy. More patients received systemic therapy over time (from 19% in 2005 to 26% in 2009, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). Patients who were less than 70 years old or had adenocarcinoma were more likely to receive systemic therapy (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001 for both). The median survival, regardless of age, for those selected to receive first\u2010line cisplatin\u2010gemcitabine chemotherapy was longer than that for those receiving other nonpemetrexed platinum doublets at 11.6 months (<jats:italic>P<\/jats:italic>\u2009=\u2009.0002). Patients with nonsquamous histology who were treated with second\u2010line pemetrexed had longer median survival than those treated with docetaxel (19.8 vs 14.1 months, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Most patients with metastatic NSCLC in the general population still do not receive systemic therapy. Those selected for first\u2010 and second\u2010line systemic treatment, including older patients, have survival outcomes comparable to clinical trial results. Older patients and patients with squamous histology are less likely to receive chemotherapy. The low levels of treatment utilization in this study warrant further investigation. <jats:bold><jats:italic>Cancer<\/jats:italic> 2015;121:2562\u20132569<\/jats:bold>. \u00a9 <jats:italic>2015 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.29386","type":"journal-article","created":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T18:09:41Z","timestamp":1429294181000},"page":"2562-2569","source":"Crossref","is-referenced-by-count":64,"title":["Real\u2010world chemotherapy treatment patterns in metastatic non\u2013small cell lung cancer: Are patients undertreated?"],"prefix":"10.1002","volume":"121","author":[{"given":"Adrian G.","family":"Sacher","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Canada"},{"name":"Lowe Center for Thoracic Oncology Dana\u2010Farber Cancer Institute, Harvard Medical School Boston Massachusetts"},{"name":"Faculty of Medicine University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa W.","family":"Le","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Canada"},{"name":"Department of Biostatistics, Princess Margaret Cancer Center University Health Network Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthea","family":"Lau","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Canada"},{"name":"Department of Biostatistics, Princess Margaret Cancer Center University Health Network Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig C.","family":"Earle","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto Canada"},{"name":"Institute for Clinical Evaluative Sciences Toronto 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