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ORAL 27 - Care (ID 123)
- Event: WCLC 2015
- Type: Oral Session
- Track: Advocacy
- Presentations: 1
ORAL27.02 - Patients' Attitudes and Physicians' Perceptions Toward Maintenance Therapy for Advanced NSCLC: A Multicenter Italian Survey (ID 1448)
10:45 - 12:15 | Author(s): E. Capelletto
Pemetrexed maintenance therapy (MT) after induction with platinum-based chemotherapy plus pemetrexed has recently become a concrete strategy of treatment for advanced non-squamous NSCLC patients, by extending survival, delaying disease progression, and maintaining quality of life. However, the benefit of the MT has to be weighed against the potential burden of a long-term treatment, and thus patients’ perception and preferences should be taken into account in the definition of the strategy of treatment.
After conducting a focus group with 8 physicians dealing with NSCLC and concerning their opinions about the MT from a clinical and emotional point of view, a 12 questions-anonymous survey has been carried out in 13 Italian Oncologic Institutions and supported by WALCE (Women Against Lung Cancer in Europe), with the aim to evaluate patients' attitude toward the MT, the benefit they expected and to provide data about physicians awareness about patients’ inclinations. The Distress Thermometer Questionnaire has also been employed to perform a bio-psycho-social-spiritual assessment of the evaluated patients. Patients' evaluations have been performed at the beginning of chemotherapy (T0) and at the beginning of MT (T1), while physicians fill the survey only once during the study.
The survey has been prospectively (1st of December 2014-28th of February-2015) administered to 92 newly diagnosed advanced non-squamous NSCLC patients (58,7% male, median age 63,9 years), EGFR wilde-type, consecutively enrolled and suitable for first-line platinum/pemetrexed-based chemotherapy, and to 37 referring physicians (equally distributed per gender, with median age 41 years). To date, after platinum-based induction chemotherapy (median number of cycles 3,3, equally distributed between cisplatin and carboplatin), 24 of 92 patients enrolled (26,1%) have already started the pemetrexed MT. Main results are shown in Table 1. Most of the patients (73,9%) are in favor of MT. Until life expectation is over 3 months, data show agreement between patients' and physicians' perceptions of patients. When OS benefit drops at 1 month the two perceptions split: a lower percentage of patients (44,5%) would perform MT. By contrast, even without OS benefit, 71,3% of patients accept MT if it can increase symptom control. Figure 1
Study is ongoing and data about T1 evaluations are still immature. Our preliminary data suggest the importance, when MT communication is done by the referral physician, to stress more symptoms control rather than survival rates.
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P1.10 - Poster Session/ Advocacy (ID 228)
- Event: WCLC 2015
- Type: Poster
- Track: Advocacy
- Presentations: 1
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P1.10-005 - Immunotherapy, What Lung Cancer and Melanoma Patients ...and Physicians, Know (ID 1058)
09:30 - 17:00 | Author(s): E. Capelletto
Advances in the understanding of the role of the immune system in tumor immune-surveillance have led in the last few years to the development of a series of new drugs rapidly affirmed as new paradigm of treatment for certain cancers, like advanced melanoma. The recent re-evaluation of the immunogenicity of Non-small Cell Lung Cancer (NSCLC) has opened a new field of research, with a new attempt to apply immunotherapy also to this disease.
A 9 question-anonymous survey has been carried out by AIOM (Associazione Italiana di Oncologia Medica) and supported by WALCE (Women Against Lung Cancer in Europe) with the purpose to investigate patients’ knowledge about the immunotherapy, their expectations in terms of toxicity and efficacy, but also to evaluate how much physicians are becoming confident about the immunotherapy and their expected impact on daily clinical practice. The survey has been distributed, between 10th of November 2014 and 19th of March 2015, to 77 NSCLC patients (prevalently men and over 60 years old) and 89 melanoma patients (equally distributed for gender and age) within various Italian Oncologic Units. A similar electronic survey has been filled out by 128 and 68 physicians dealing with NSCLC and Melanoma, respectively, who reported to employ immunotherapy in their clinical practice in 55% and 74% of cases, respectively, and to have participated into clinical trials with immunotherapy in 39% and 41% of cases.
Patients' knowledge and expectations about immunotherapy resulted to be extremely heterogeneous. Only 19% of NSCLC patients, compared to 73% of melanoma patients, declared to have performed immunotherapy in their clinical history. Main results about patients' perception about immunotherapy are shown in Table 1. NSCLC and melanoma physicians globally reported a positive attitude for this new kind of treatment, postulating a general improving of their clinical practice in the next future (88% and 99% of cases, respectively). They have speculated a non-limiting toxicity profile of this drugs in 77% and 76% of cases, respectively. Figure 1
Although the role of immunotherapy for NSCLC treatment, as already happened for melanoma in the past few years, still need a confirmation by the results of the ongoing clinical trials, patients and physicians widely express great expectation on this kind of treatment, waiting for a large anti-cancer efficacy together with a low toxicity.