NSCLC: estrogen supplementation tied to better OS, CSS in women

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Postmenopausal estrogen monotherapy (EM) is associated with better OS and cancer-specific survival (CSS) in older women with stage III-IV NSCLC.
  • Combined estrogen-progesterone therapy was associated with improved OS, but not CSS.

Why this matters

  • Higher estrogen levels could explain longer survival in women vs men.

Study design

  • 6958 women aged ≥65 years diagnosed with stage III-IV NSCLC from the Surveillance, Epidemiology and End Results database who received EM within 6 months before cancer diagnosis (n=283) or not (n=6675).
  • 1:4 propensity matching of 1395 patients (279 received EM).
  • Funding: None disclosed.

Key results

  • Matched cohort follow-up was 46.5 months with EM and 50.6 months without.
  • OS was 8.0 months with EM vs 6.4 months without in the matched cohort (P=.0212).
  • After multivariable analysis, EM was significantly associated with better OS in matched cohort (aHR, 0.84; 95% CI, 0.73-0.97) and CSS (HR, 0.83; 95% CI, 0.71-0.97).
  • After multivariable analysis, systemic EM significantly reduced the rates of skeletal-related events (HR, 0.80; P=.03), but had no effect on the thromboembolic events, myocardial infarctions, or cerebrovascular events.
  • Combined estrogen-progesterone therapy significantly improved OS (HR, 0.84; P=.04), but not CSS (HR, 0.91; P=.30).

Limitations

  • No data on some potential confounders.