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K.W. Culver

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-020 - Symptoms of Bone and Liver Metastases in Patients with ALK+ Non-Small Cell Lung Cancer (NSCLC) (ID 857)

      09:30 - 17:00  |  Author(s): K.W. Culver

      • Abstract
      • Slides

      Among patients with ALK+ NSCLC who develop metastases, common metastatic sites include brain, bones, and liver. Although the symptomatic profile of ALK+ NSCLC patients with brain metastases is well documented, information remains limited for patients with bone metastases or liver metastases.

      Data from 2 large US administrative claims databases—IMS LifeLink Health Plan Claims (01/2001 – 03/2014) and Truven Health Analytics MarketScan (01/2002 – 09/2012)—were pooled for this retrospective study. Among adult patients with a lung cancer diagnosis, ALK+ NSCLC patients were identified based on prescription fills for crizotinib. Patients were analyzed if they had ≥60 days of follow-up before and ≥30 days after the bone metastasis or liver metastasis diagnosis date.

      A total of 231 ALK+ NSCLC patients were selected: 191 had bone metastasis and 104 had liver metastasis. For the bone metastasis sample, median age was 54.9 years, 39.3% were male, and median time from first lung cancer diagnosis to the bone metastasis diagnosis was 30 days. The frequency of symptoms frequently associated with bone metastasis increased after bone metastasis diagnosis compared to before. Common skeletal-related events included pathologic fractures (before: 0.5% vs. after: 12.6%), spinal cord compression (2.6% vs. 5.2%), and bone radiation therapy (12.6% vs. 62.3%).Other common symptoms were weakness/fatigue (before: 24.6% vs. after: 46.6%), anemia (10.5% vs. 33.0%), back pain (8.4% vs. 22.5%), bowel dysfunction (6.8% vs. 20.9%), and neoplasm-related pain (0.0% vs. 14.1%). For the liver metastasis sample, median age was 54.0 years, 42.3% were male, and median time from first lung cancer diagnosis to first liver metastasis diagnosis was 151 days. The frequency of symptoms frequently associated with liver metastasis also increased compared to before liver metastasis diagnosis, where most common symptoms were nausea/vomiting (before: 21.2% vs. after: 42.3%), abdominal pain (20.2% vs. 34.6%), fever/sweating (6.7% vs. 27.9%), edema (6.7% vs. 25.0%), jaundice (0.0% vs. 3.8%), and fatigue (29.8% vs. 46.2%).

      ALK+ NSCLC patients experience an increased symptomatic burden after developing bone metastasis or liver metastasis. Further research is warranted to analyze the impact of the symptomatic burden on patient quality of life and other outcomes as well as the potential benefit of instituting second-generation ALK-inhibitors earlier in the treatment course.

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