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Vera Hirsh



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    MA18 - Modelling, Decision-Making and Population-Based Outcomes (ID 920)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 13:30 - 15:00, Room 201 F
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      MA18.08 - Discussant - MA 18.05, MA 18.06, MA 18.07 (ID 14652)

      14:10 - 14:25  |  Presenting Author(s): Vera Hirsh

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-108 - Oncologist Treatment Considerations and Selection in EGFR M+ NSCLC (ID 13763)

      12:00 - 13:30  |  Presenting Author(s): Vera Hirsh

      • Abstract
      • Slides

      Background

      The treatment landscape for EGFR M+ stage IIIb/IV NSCLC has significantly changed in the past few years: at the end of 2015, 3rd generation TKI osimertinib was approved for the treatment of EGFR T790M+ NSCLC, and in 2018, osimertinib was approved for the first-line treatment of EGFR M+ patients. As such, there is much debate amongst oncologists around which TKI to prescribe to patients first, now that more targeted treatments are available. The aim of this study was to assess current attitudes towards decision making for TKI sequencing to determine what matters most when selecting a treatment and what challenges oncologists face.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A representative online survey was conducted with 310 HCPs (Oncologists, Pulmonologists, Respiratory Surgeons and Internal Respiratory Specialists) across four countries (China, Germany, Japan and USA) between April 2018 and May 2018.

      4c3880bb027f159e801041b1021e88e8 Result

      For all four countries and irrespective of treatment line, increasing overall survival (OS), followed by increasing quality of life (QoL) emerged as the most important treatment ambitions when prescribing TKIs. However, examination of treatment goals in the first-line setting revealed that clinically meaningful OS stands out for the US, Germany and Japan. In contrast for China, offering a clinically meaningful progression-free survival (PFS), OS, and improved health related QoL appear to be of equal importance.

      Predictability of treatment outcome in first-line therapy was also a relevant influence on treatment choice. This included a predictable pattern of resistance to TKIs for the majority of patients, efficacy in specific EGFR M+ subtypes, availability in flexible dose adjustment and if a compound was part of a sequence of targeted treatments which may delay time to chemotherapy.

      In terms of the sequencing of TKIs, 55% strongly prefer a treatment sequence offering maximum time on targeted therapies. Furthermore, there is a strong need across all countries for information on potential resistance mutations before changing current treatment practice – and over a third (36%) of all HCPs agreed that they do not feel they have all the data required to make informed decisions on how to sequence EGFR M+ NSCLC treatments.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The study confirms that increasing survival time across treatment lines is the overarching ambition when using TKIs in EGFR M+ NSCLC together with increasing QoL. In order to overcome uncertainties regarding the appropriate treatment decisions for patients EGFR M+ NSCLC, HCPs require more information about the possible impact of treatment sequencing on extending survival.

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