Virtual Library

Start Your Search

Haocheng Li



Author of

  • +

    MA14 - Survivorship, Socioeconomic and End-of-Life Considerations (ID 915)

    • 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, 10:30 - 12:00, Room 205 BD
    • +

      MA14.11 - Factors Associated with Early Mortality in Non-Small Cell Lung Cancer Patients Following Systemic Anti-Cancer Treatment (ID 12970)

      11:40 - 11:45  |  Author(s): Haocheng Li

      • Abstract
      • Presentation
      • Slides

      Background

      To determine a 30-day mortality rate benchmark and assess factors associated with early mortality of non-small cell lung cancer (NSCLC) patients following receipt of systemic anti-cancer therapies (SACT).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In a 10-year population-based analysis, NSCLC patients receiving SACT in 2005-2014, with or without other treatments, and captured in the Glans-Look Lung Cancer Database, which contains demographic, clinical, pathological, treatment and outcome data were reviewed. 30-day mortality after most recent SACT cycle was calculated, and end-of life (EOL) regimen changes in the last 14 days of life were identified. Univariate analysis and multivariable logistic regression were used to identify demographic, tumor or treatment-related factors that correlated with mortality risk.

      4c3880bb027f159e801041b1021e88e8 Result

      1044 eligible NSCLC patients receiving at least one cycle of SACT in 2005-2014 were identified. 51% were female, 62% adenocarcinoma, 79% current/former smokers, 83% advanced stage at diagnosis, and 77% receiving palliative-intent treatment. 233 (22.3%) deaths occurred ≤ 30 days following SACT receipt, and 32 (13.7%) EOL regimen changes identified. Risk of early mortality decreased for never-smokers and those receiving SACT between 2010-2014, and increased in association with male gender, advanced disease at diagnosis, palliative-intent treatment, and use of EGFR-targeting agents. No factors were associated with a decreased risk of EOL regimen change. (Table 1). The predominant SACT-modality among those experiencing 30-day mortality was EGFR-targeting agents (54%).
      abstract #12790 table.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our findings from a real-world population identify several factors which affect the risk of early mortality in NSCLC patients following SACT, and establish a 30-day mortality benchmark for Canadian NSCLC populations. Evolving SACT modalities may facilitate an increased use of SACT at EOL and associated early mortality; however, in this cohort, decreased early mortality risk in the 2010-2014 timeframe suggests concomitant evolution of decisions regarding EOL SACT and/or palliative and EOL care may be underway at our centre, but represents an area for ongoing investigation.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
    • +

      P2.01-13 - Number, Rather Than Location of Metastases, Dictates Outcome in Stage IV, M1b, Non-Small Cell Lung Cancer   (ID 12799)

      16:45 - 18:00  |  Author(s): Haocheng Li

      • Abstract
      • Slides

      Background

      To assess the impact of location versus number of extra-pulmonary metastatic sites (EPMS) on survival in stage IV non-small cell lung cancer (NSCLC).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A large scale, multi-year retrospective analysis was conducted on patients with a new diagnosis of stage IV, M1b (AJCC 7th edition) NSCLC between 1999-2013. Demographic, clinical, histopathological, treatment and outcome data was extracted from the Canadian institutional Glans-Look Lung Cancer Database. We assessed the impact of location and number of EPMS and identified correlates of overall survival using the Kaplan-Meier method and Cox regression.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 2,065 NSCLC patients with EPMS were identified. Median age was 67 (IQR 58-75) years, 52% were male, and 78% reported a history of smoking. 60% had one EPMS, and 40% had two or more EPMS. Among those with only one EMPS, most frequent organ involvement included bone (40%), brain (32%), liver (13%) and adrenal (10%). Median overall survival (mOS) was worst in those with liver metastasis and best in those with adrenal metastasis (2.0 vs. 5.2 months, p=0.015). However, outcomes based on organ site involvement did not retain prognostic significance in multivariable analysis after controlling for other measured confounders. Compared to patients with one EPMS, individuals with ≥ 2 EPMS experienced worse outcomes (mOS 3.9 vs 2.9 months, p<0.001), and were associated with worse prognosis in Cox regression analysis (HR 1.5, 95%CI 1.3-1.7, p<0.001). A statistically and clinically significant inverse relationship persisted between increasing number of EMPS sites and mOS. Those patients who received systemic anti-cancer therapy or surgical resection of metastatic disease (received by 25% and 3% of total cohort respectively) demonstrated the most improved mOS, regardless of number or location of EMPS (10.0 vs 2.0 months, p<0.001, and 9.0 vs 3.0 months, p<0.001, respectively).

      8eea62084ca7e541d918e823422bd82e Conclusion

      We conclude that number, rather than location of EPMS is a prognostic factor in patients with stage IV M1b NSCLC. A simple count of metastatic sites at diagnosis may be of clinical value in in the management and advanced care planning for patients with metastatic NSCLC. Of note, this could assist in identification of patients who would benefit from either more aggressive treatment or best supportive care, and may be an important consideration in future clinical trial design. Overall, this study reinforces the need to advance efforts to determine and mitigate the factors predisposing patients to develop metastatic disease, and develop initiatives to reduce the number of patients presenting with advanced disease.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

    • +

      P2.01-28 - Gender and Systemic Treatment Patterns: Impacts on the Overall Survival of Stage IV NSCLC 2010 – 2014 Diagnoses (ID 13368)

      16:45 - 18:00  |  Author(s): Haocheng Li

      • Abstract
      • Slides

      Background

      Our previous work reports only ~25% systemic treatment uptake in stage IV non-small cell lung cancer (NSCLC) patients and proposed the availability of more tolerable regimen as one way of improving survival for NSCLC patients. The current study followed-up with the systemic treatment trend in stage IV NSCLC patients from 2010 to 2014, the era where effective and tolerable targeted agents such as EGFR- tyrosine kinase inhibitors (TKIs) and ALK inhibitors are available, to determine changes in clinical and treatment patterns impacting NSCLC survival over time.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Using the Glans-Look Lung Research (GLR) database, we defined the clinical features of stage IV NSCLC patients from 2010 to 2014, determined the impact of systemic treatment patterns and uptake rates on overall survival (OS).The findings were summarized with descriptive statistics (Fisher’s Exact tests) and Kaplan Meier survival curves using SPSS. Statistical significance was set at p value < 0.05 and 95% confidence intervals.

      4c3880bb027f159e801041b1021e88e8 Result

      Among the 470 patients diagnosed between the year 2010 – 2011, and 724 in 2012 – 2014, 26% and 33% received 1st line systemic treatment respectively. Overall, there was increased use of EGFR and ALK targets (18% in 2010 – 2011 versus 34% in 2012 – 2014 of all 1st line therapy) and a 13% decrease in platinum-based doublet (PBD) uptake over the years, (p = 0.001). This pattern of change was similar for patients ≤70 years versus >70 (p < 0.001). However, for female patients, PBD use remain constant despite the increased targeted agents uptake, (p = 0.001). The median OS was slightly better for female in the subsequent years, 7 (95% CI: 6 – 8) versus 4 (95% CI: 3 – 5) months, p = 0.036. In EGFR/ALK mutation positive patients who received 1st line TKIs, a non-statistically significant lower OS was observed in 2012 – 2014 compared to the previous years (p = 0.188). No significant difference in the OS between the year groups for patients with no actionable mutation treated with 1st line PBD (p = 0.393).

      8eea62084ca7e541d918e823422bd82e Conclusion

      In stage IV NSCLC, systemic treatment uptakes slightly increased with targeted agents, however this may not add up to overall survival benefits for the disease. Targeted agents may confer more benefits to female patients. Outcome results from multivariate analysis will be presented and discussed.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.