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J. Passweg

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      180P - Significant progress in palliative treatment of NSCLC over the last decades: Correlation of treatment milestones with survival in unselected patients (ID 645)

      12:30 - 13:00  |  Author(s): J. Passweg

      • Abstract
      • Slides

      Therapeutic options for patients (pts) with metastatic non-small cell lung cancer (mNSCLC) have considerably changed during the last decades. Introduction of 3rd-generation chemotherapeutic agents (1997), molecularly targeted drugs (2009) and immune checkpoint inhibitors (2015) are milestones in the treatment of NSCLC. We analyzed the outcomes of all consecutive patients with mNSCLC in a single institution to determine whether these milestones improved the outcome of unselected patients in a real-world setting.

      576 consecutive patients with palliative treatment for NSCLC at the University Hospital Basel between 1990 and 2016 were analyzed. Probabilities of survival were calculated using the Kaplan-Meier estimator. Groups were compared using the log-rank test. Multivariate analysis was performed to determine factors associated with improved overall survival (OS).

      Mean age at diagnosis was 62.9 years, 68% were male, 81% were smokers and 55% had adenocarcinoma. Four cohorts of pts were created according to the described milestones in NSCLC therapy and approval of the drugs. There was a significant statistical difference in median OS for the four-time periods: 1990–1996 8.1 months, 1997–2008 10.7 months, 2009–2014 9.0 months, and 2015–2016 12.4 months (p = 0.027). The four cohorts did not differ significantly in gender, stage, performance and smoking status. In the multivariate analysis, the time period was an independent prognostic factor for OS (p < 0.001). A further independent prognostic factors for OS was sequential therapy with at least two therapies (p = 0.002). Lack of response to 1st-line therapy was an independent negative prognostic factor (p < 0.0001).

      Our analysis shows that results obtained in prospective clinical trials are applicable to an unselected real-world population of NSCLC pts. In the period from 2009 to 2014 there was no overall progress, perhaps because introduction of targeted agents benefitted only a minority of selected pts harboring a specific molecular aberration. On the whole, a clinically meaningful and encouraging improvement of survival in m NSCLC was observed in the last decades.

      Clinical trial identification:

      Legal entity responsible for the study:
      University Hospital Basel

      Has not received any funding

      All authors have declared no conflicts of interest.

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