{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:54:16Z","timestamp":1793192056548,"version":"4.5.0"},"reference-count":56,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bristol Myers Squibb"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Treatment for advanced non-small-cell lung cancer (NSCLC) has evolved substantially over the past decade, necessitating evaluation of real-world treatment patterns and effectiveness before and after the introduction of newer therapies. Methods: This retrospective cohort study included adult patients initiating a non-curative first-line therapy for advanced NSCLC between 2014 and 2021 at the IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST), with follow-up through 2022. Overall survival (OS) and real-world progression-free survival from the start date of the first line of therapy for advanced NSCLC were estimated using Kaplan\u2013Meier methods. Results: Overall, 910 patients were included; at diagnosis, 83% had a de novo diagnosis and 17% had recurrent disease. During the study, 41% of patients received platinum-based chemotherapy alone; 22% received non-platinum-based chemotherapy alone; 21% received anti-programmed death (PD)-(ligand [L])1 immune checkpoint inhibitors (ICIs), alone or with chemotherapy; and 16% received targeted therapy (single-agent tyrosine kinase inhibitors) as first-line therapy for advanced disease. From 2014 to 2021, the proportion of patients receiving first-line anti-PD-(L)1 ICIs increased from 0% to 58% and the proportion of those receiving first-line platinum-based chemotherapy decreased from 65% to 6%. Median (95% CI) OS was 8.2 (7.5\u20139.2) months; the minimum-to-maximum range of median OS was 6.0\u20137.4 months from 2014 to 2017 and 8.4\u201315.9 months from 2018 to 2021. Median OS was numerically longer in patients with recurrent disease versus a de novo diagnosis, first-line targeted versus other therapy, high versus low PD-L1 expression, and non-squamous\/other versus squamous histology. Conclusions: This study provides real-world data further supporting (i) the benefits of precision targeted therapy for patients with advanced NSCLC and actionable genomic alterations and (ii) the positive impact of immunotherapy approvals on the treatment paradigm for advanced NSCLC.<\/jats:p>","DOI":"10.3390\/cancers18030538","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T13:33:50Z","timestamp":1770384830000},"page":"538","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-World Treatment Patterns and Survival in Patients with Advanced Non-Small Cell Lung Cancer: An Italian Retrospective Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Angelo","family":"Delmonte","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-9172","authenticated-orcid":false,"given":"Nicola","family":"Gentili","sequence":"additional","affiliation":[{"name":"Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-9273","authenticated-orcid":false,"given":"Andrea","family":"Roncadori","sequence":"additional","affiliation":[{"name":"Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0366-792X","authenticated-orcid":false,"given":"Roberta","family":"Maltoni","sequence":"additional","affiliation":[{"name":"Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9261-6467","authenticated-orcid":false,"given":"Valentina","family":"Danesi","sequence":"additional","affiliation":[{"name":"Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Hindocha","sequence":"additional","affiliation":[{"name":"IQVIA Ltd., London W2 1AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e1tia","family":"Leal","sequence":"additional","affiliation":[{"name":"IQVIA Ltd., 2740-266 Porto Salvo, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4076-0760","authenticated-orcid":false,"given":"Stavros","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"IQVIA Ltd., 1303 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9858-0120","authenticated-orcid":false,"given":"Marta","family":"Mella","sequence":"additional","affiliation":[{"name":"IQVIA Ltd., 20124 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lay-Flurrie","sequence":"additional","affiliation":[{"name":"IQVIA Ltd., London W2 1AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Emanuel","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge UB8 1DH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Rault","sequence":"additional","affiliation":[{"name":"Data Gnosis, 35000 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrudula B.","family":"Glassberg","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Madison, NJ 07940, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8834-1296","authenticated-orcid":false,"given":"Adam","family":"Lee","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge UB8 1DH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ 08540, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-3175","authenticated-orcid":false,"given":"Ilaria","family":"Massa","sequence":"additional","affiliation":[{"name":"Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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