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J. Klein



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    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-054 - Adjuvant Chemotherapy Uptake in Patients with NSCLC after Complete Resection: Single Institution/Single Area Experience (ID 3914)

      14:30 - 15:45  |  Author(s): J. Klein

      • Abstract

      Background:
      Adjuvant chemotherapy (AC) is recommended in patients (pts) with stages IB (tumour of ≥4 cm in diameter), IIA, IIB, and IIIA of non-small cell lung cancer (NSCLC) after complete resection. According to metaanalyses it prolongs survival of pts in good PS and age less than 75 years. The selection of patients is influenced by the limited profit of AC, possible toxicity and the lack of predictive biomarkers. There are only few retrospective studies describing routine utilization of AC in specified areas. Presented AC uptake in stages II and III varies from 20 % to 24% in Canada and USA. .

      Methods:
      A retrospective study of AC uptake in pts with NSCLC from a Moravian region with 600.000 inhabitants was conducted, evaluation period was 2006-2013. Treatment strategy of all patients was discussed by surgeons and pneumo-oncologists on the interdisciplinary tumour boards before and after surgery. Uptake and compliance of AC was evaluated according to age, sex, TNM stages, type of surgery and other cofactors. AC was given in regimens using doublets of platinum with vinorelbine (rarely gemcitabine or paclitaxel). Vinorelbine was applied both intravenously (25 mg/m[2]) and orally (60 - 80 mg/m[2]). The choice of cisplatinum (80mg/m[2]) or carboplatinum (AUC 5) was based on patient preference, PS and comorbidities. .

      Results:
      Out of all 1557 pts with lung cancer, NSCLC was present in 1293 pts. 308 pts underwent curative-intent surgery and complete resection was achieved in 295 pts. 226 pts were pts with stages IB, II and IIIA and AC was applied in 183 pts (80.1%), in 34 (18.6 %) pts together with neoadjuvant chemotherapy. AC was not applied in 43 (19.9 %) pts after radical surgery due to worse PS, comorbidities, complications after surgery or patient´s refusal. The mean age of pts with AC was 65 years, 66,7% were men, 48,9 % women, 49,9 % were current smokers, 40,0% ex-smokers and 10,1 % non-smokers. Age, sex and smoking habits were not statistically different between pts with and without AC. Compliance with AC was very good, 82% of pts accomplished planned therapy.

      Conclusion:
      The optimal uptake of AC in routine practice depends on the intensive communication between the patient, surgeons and pneumoocologists. The individual decision is important in a context to the patients´ health status, tumour parameters and the potential risk/ benefit of therapy. Study was supported by grant AZV 16-32318A