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Paul Wheatley-Price



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    MA02 - Improving Outcomes for Patients with Lung Cancer (ID 895)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 10:30 - 12:00, Room 201 BD
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      MA02.09 - Discussant - MA 02.05, MA 02.06, MA 02.07, MA 02.08 (ID 14576)

      11:20 - 11:35  |  Presenting Author(s): Paul Wheatley-Price

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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    P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.01-21 - Safety of Durvalumab Retreatment in Advanced NSCLC Patients Who Progressed Following Initial Disease Control In ATLANTIC (ID 12386)

      16:45 - 18:00  |  Author(s): Paul Wheatley-Price

      • Abstract
      • Slides

      Background

      In ATLANTIC, patients who completed a year of durvalumab (anti-PD-L1) treatment but later progressed off therapy were eligible for retreatment. We evaluated safety in these patients compared with the overall study population.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      ATLANTIC (NCT02087423) was a Phase 2, open-label, single-arm trial in patients with Stage IIIB–IV NSCLC who had received ≥2 prior systemic treatment regimens, including one platinum-based. The study included three independent cohorts. In C1 (EGFR+/ALK+) and C2 (EGFR−/ALK−), enrollment was enriched for patients with ≥25% of tumor cells (TC) expressing PD-L1, while patients in C3 (EGFR−/ALK−) only had PD-L1 TC ≥90%. Patients received durvalumab 10 mg/kg q2w for ≤12 months. Patients who achieved and maintained disease control but then progressed after completing the initial 12-month treatment period were offered retreatment for a maximum of 12 months of further treatment. Safety and tolerability was a secondary outcome.

      4c3880bb027f159e801041b1021e88e8 Result

      As of November 7, 2017, of 442 patients in the ATLANTIC full analysis set, 102 (23.1%) had completed 12 months of initial treatment and 95 (21.5%) had disease control at the end of initial treatment. A total of 40 patients started retreatment. The median actual duration of exposure to durvalumab was 16.0 weeks (range 1–62; 40.1% of patients on treatment for ≥24 weeks) during initial treatment and 18.1 weeks (range 2–52; 37.5% of patients on retreatment for ≥24 weeks) during retreatment. The table shows safety during initial treatment and retreatment.

      Initial treatment (n=444)

      Retreatment phase (n=40)

      Cohort,* n (%)

      C1 (EGFR+/ALK+)

      111 (25.0)

      7 (17.5)

      C2 (EGFR−/ALK−)

      265 (59.7)

      26 (65.0)

      C3 (EGFR−/ALK−; TC ≥90%)

      68 (15.3)

      7 (17.5)

      Any TRAE, n (%)

      256 (57.7)

      19 (47.5)

      Grade ≥3 TRAEs

      42 (9.5)

      6 (15.0)

      TRAEs leading to death

      0

      2 (5.0)

      Serious TRAEs

      28 (6.3)

      4 (10.0)

      TRAEs leading to discontinuation

      10 (2.3)

      4 (10.0)

      Safety analysis set. *A more detailed analysis of exposure and safety by cohort will be presented. Causes of death were: pneumonitis and respiratory failure; cardiac arrest. TRAE=treatment-related adverse event.

      8eea62084ca7e541d918e823422bd82e Conclusion

      A large proportion of patients (37.5%) maintained retreatment for ≥24 weeks, suggesting that patients who originally completed 12 months of treatment can tolerate sustained retreatment. The tolerability profile of durvalumab upon retreatment was similar to that seen during initial treatment, although there were two treatment-related deaths during the retreatment phase. Retreatment with anti-PD-L1 may be feasible for selected patients with NSCLC who demonstrate original benefit and progress off therapy.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 964)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.15-08 - Impact and Feasibility of a Support Group for Women with Lung Cancer (ID 12647)

      16:45 - 18:00  |  Presenting Author(s): Paul Wheatley-Price

      • Abstract
      • Slides

      Background

      Patients with lung cancer have limited psychosocial supports in the community. Participation in support groups provides emotional, social and educational support and may be beneficial for cancer patients. In our city there are no support groups for patients with lung cancer. We assessed the impact and feasibility of a lung cancer support group for women.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We conducted a weekly, 1.5-hour psycho-education support group for 6 sessions in 2017. Sessions were facilitated by a trained social worker with long experience in psychosocial oncology. Pre- and post-intervention quality of life tools were administered: the Canadian Problem Checklist (CPC), Functional Assessment of Cancer Therapy-Lung (FACT-L), Impact of Events Scale (IES), and the Hospital Anxiety and Depression Scale (HADS). Median changes in scores were calculated. A negative (-) change represents improvement in the domain.

      4c3880bb027f159e801041b1021e88e8 Result

      10 women were enrolled, 60% completed the program. Demographics were available for 8 participants: median age 68 (range 26-80); median diagnosis year 2016 (range 2000-2017); 3 vs 5 women were ECOG PS 0 vs 1; 1 current smoker, 2 past smokers; 5 with metastatic disease; 5 undergoing palliative systemic therapy, 1 undergoing curative therapy, 1 had completed curative therapy,1 receiving best supportive care. Both pre- and post-intervention tools were completed by 60% of participants. The CPC showed that 67% had reduced/stable problems after the intervention. The FACT-L, IES and HADS tools and their sub-scales generally showed a favourable change after the intervention. See Table 1 for the median pre- and post-intervention scores and median change in scores. 100% of participants agreed or strongly agreed that the group helped them cope with lung cancer.

      Table 1

      Scale

      Pre-intervention score, median [IQR] Post-intervention score, median [IQR] Change in score, median [IQR]
      FACT-L 1.4 [1.0-1.9] 1.9 [0.8-2.1] 0 [-0.1-0.6]
      Physical wellbeing 1.1 [1.0-1.7] 1.6 [0.9-2.6] 0 [0-0]
      Social/family wellbeing 0.6 [0.3-1] 0.7 [0.2-1.0] -0.1 [-0.3-0.4]
      Emotional wellbeing 0.3 [0.3-1] 0.7 [0-1.0] 0.3 [-0.7-0.3]
      Functional wellbeing 1.6 [1.2-2] 1.7 [1.1-2.4] 0.4 [-0.3-0.6]
      Additional concerns 1.7 [0.6-2.5] 2.1 [0.4-2.4] -0.1 [-0.3-0.4]
      Impact of Events 1.2 [0.6-1.9] 0.5 [0.2-1.4] -0.4 [-0.7-0.1]
      Avoidance 1.9 [0.4-2.3] 0.5 [0.2-1.4] -0.2 [-0.8-0.5]
      Intrusion 1.6 [1.1-1.9] 0.9 [0.3-1.3] -0.8 [-1.0-(-0.4)]
      Hyperarousal 0.7 [0.2-1.0] 0.3 [0.2-1.3] 0 [-0.3-0]
      HADS 0.7 [0.3-1.1] 0.9 [0.8-1.1] 0 [-3-0.6]
      Depression 0.6 [0.4-1.0] 0.9 [0.6-1.1] -0.1 [-0.3-0.6]
      Anxiety 0.6 [0.2-1.3] 1.0 [0.6-1.5] 0 [-0.3-0.3]

      8eea62084ca7e541d918e823422bd82e Conclusion

      A support group for women with lung cancer was feasible and quality of life improved in several domains. Support groups and other community resources should be more widely available for patients with lung cancer.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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