PURPOSE: The aim of our study was to evaluate if therapeutic success in the first-line of anticancer treatments in patients with NSCLC may predict treatment success in the following lines. METHODS: We analyzed the data of patients with NSCLC stage III/IV from the TULUNG registry separately for chemotherapy, TKIs, ALK inhibitors, and immunotherapy in the first line during the years 2011-2019. "Succesful treatment " was defined as PFS ≥ 6 months, a "good responder " was a patient with ˃50% of "successful treatment " lines. Treatment responses were analyzed separately for each drug group. Descriptive statistics, Fisher exact test, Pearson Chi-Squared test, log-rank test, and univariate/multivariate logistic regression models were used. RESULTS: The first-line TKI therapy was successful in 66.2%, while good responders accounted for 50.7% of the cohort and their rates were similar for all types of TKIs. First-line platinum-based chemotherapy was successful in 43.1% and 48.6% for combinations with pemetrexed and bevacizumab, respectively. Good responders accounted for 29.5% and 25.9%, respectively. In the group of ALK inhibitors, we observed treatment success in 52.3% of cases, while alectinib showed the highest effectiveness (up to 70%). Good responders constituted 50% of the group. In the first-line immunotherapy group, survival benefit was observed in 52.3%, and good responders constituted 52.3% of the cohort. CONCLUSION: We concluded that the treatment success in first-line therapies in patients with NSCLC may predict survival benefits in the subsequent lines, particularly in EGFR- or ALK-positive disease and immunotherapy-treated patients.

2nd Faculty of Medicine Charles University Prague Czech Republic

Department of Pneumology and Thoracic Surgery Bulovka Hospital Prague Czech Republic

Department of Pneumology University Hospital Hradec Kralove Hradec Kralove Czech Republic

Department of Pneumology University Hospital Motol Prague Czech Republic

Department of Pneumology University Hospital Pilsen Pilsen Czech Republic

Department of Respiratory Diseases University Hospital Brno Jihlavska Street 20 625 00 Brno EU Czech Republic

Department of Respiratory Medicine Thomayer Hospital Prague Czech Republic

Department of Respiratory Medicine University Hospital Olomouc Olomouc Czech Republic

Faculty of Medicine Charles University Prague Hradec Kralove Czech Republic

Faculty of Medicine Charles University Prague Pilsen Czech Republic

Faculty of Medicine Masaryk University Brno Czech Republic

Faculty of Medicine Palacky University Olomouc Czech Republic

Institute of Biostatistics and Analyses Ltd Brno Czech Republic

International Clinical Research Center St Anne's University Hospital Brno Czech Republic

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