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Eric Nadler



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    EX04 - Mini Oral Abstract Session - MA08.06, MA18.02, MA19.02, MA20.11 (ID 1006)

    • Event: WCLC 2018
    • Type: Exhibit Showcase
    • Track: Advanced NSCLC
    • Presentations: 1
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      EX04.01 - Outcomes Among Patients with EGFR-Mutant Metastatic NSCLC with and without Brain Metastases (ID 13671)

      09:55 - 10:00  |  Author(s): Eric Nadler

      • Abstract
      • Slides

      Background

      Brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) are common, with reported frequencies of up to 44%. The epidermal growth factor receptor-mutant (EGFRm) subtype of NSCLC is known to have specific pathologic features that may influence patterns of metastases and outcomes. The prevalence of BM in patients with EGFRm NSCLC is unknown; however, incidence is expected to increase as new treatments emerge that prolong survival. Therefore, an understanding of the impact of BM and burden of illness in this population is needed.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A retrospective observational matched cohort study of adults with EGFRm metastatic NSCLC, with BM and without BM (NBM), between January 1, 2014, and July 31, 2016, with follow-up to March 31, 2017. Data were extracted from the iKnowMedTM electronic health record database of patients in the US Oncology Network of community oncology practices, supplemented with chart review. Patients were matched 1:1 by age categories and sex. Patients enrolled in interventional clinical trials or with other cancer diagnoses were excluded. Categorical variables were analyzed using chi-squared tests; time to treatment failure (TTF) and overall survival (OS) were assessed using the Kaplan-Meier method starting from the matched line of therapy for TTF and from NSCLC diagnosis for OS.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 402 (BM, 201; NBM, 201) patients were included; median age was 70 and 77 years, respectively (p<.05). Patients in both cohorts were predominantly female (65%), Caucasian (69%), non-smokers (42%), and had adenocarcinoma (92%). Over 90% of patients were treated in the first-line setting. Median TTF in the BM and NBM cohorts following initial treatment was 10.9 months (95% confidence interval [CI], 9.5-12.0) and 10.4 months (95% CI, 8.9-12.2), respectively. Median OS for the BM and NBM cohorts was 11.9 months (95% CI, 9.7-13.4) and 16.0 months (95% CI, 9.1-20.6), respectively (log-rank p=.017). Median OS from onset of BM in the BM cohort was 10.0 months (95% CI, 7.4-11.2). While CNS symptoms were present in both cohorts, they were significantly higher in the BM cohort; patients in the BM cohort had significantly greater use of home healthcare, physical therapy, and social work services (p<.05).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Median TTF was similar in patients with EGFRm metastatic NSCLC with BM and NBM; however, OS was significantly worse in the BM cohort. Symptom burden and healthcare resource utilization were also higher in the BM cohort. These findings highlight an unmet treatment need for patients with EGFRm NSCLC with BM.

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