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Soo Jin Seung
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P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.15-27 - Patient Characteristics, Treatment Patterns and Survival for Unresectable Stage III NSCLC in Ontario, Canada. (ID 13442)
16:45 - 18:00 | Presenting Author(s): Soo Jin Seung
- Abstract
Background
In anticipation of new treatment strategies for unresectable stage III NSCLC, we undertook a retrospective study to determine how these patients have been managed in Ontario, Canada and their survival by treatment approach.
a9ded1e5ce5d75814730bb4caaf49419 Method
Individuals diagnosed with stage III NSCLC between April 1, 2010 and March 31, 2015 were identified in the Ontario Cancer Registry (OCR). Patients with stage III disease were considered to be unresectable if no surgery was undertaken within 3 months of diagnosis. Initial treatments included: radiation (classified as curative or palliative based on treatment intent, body region, dose/fraction, number of fractions); chemotherapy categorized as single or doublet IV chemotherapy, single chemo+RT, doublet chemo+RT, oral targeted therapy. Concurrent chemo+RT (cCRT) was defined as an overlap between chemotherapy and RT, while sequential chemo+RT (sCRT) had no overlap and a 30-day window between treatments. Survival was calculated from date of diagnosis to death.
4c3880bb027f159e801041b1021e88e8 Result
24,729 individuals were diagnosed with NSCLC in Ontario during the study period; 5,243 (21.2%) were stage III and 4,542 (18.4%) were stage III unresectable. Mean age of the unresectable group was 69.7±10.3 years; 54.2% were male. 64.2% of patients were treated within 3 months of diagnosis. The frequency of treatment approach was: cCRT (21.6%), palliative RT (21.3%), curative RT (20.2%), no treatment (19.6%), chemotherapy (11.6%), sCRT (4.9%) and targeted therapy (0.7%). Median survival (IQR) was 2.9 yrs (1.7-4.8) for targeted therapy, 2.0 yrs (1.0-5.5) for cCRT, 1.4 yrs (0.7-3.4) for curative RT, 1.4 yrs (0.7-3.1) for chemotherapy, 1.2 yr (0.6-2.9) for sCRT, 0.6 yrs (0.3-1.2) for palliative RT and 0.5 yrs (0.2-1.2) for no treatment (Figure 1).
Figure 1. Kaplan-Meier survival curves for stage III unresectable lung cancer patients based on treatment type.
8eea62084ca7e541d918e823422bd82e Conclusion
Although cCRT is generally considered standard of care for stage III unresectable NSCLC, patients in Ontario receive various treatment approaches. Survival outcomes vary widely.
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P1.15-28 - Real World Treatment Patterns and Survival of Stage IV Non-Small Cell Lung Cancer (NSCLC) in Ontario, Canada. (ID 13923)
16:45 - 18:00 | Presenting Author(s): Soo Jin Seung
- Abstract
Background
The majority of NSCLC patients are diagnosed with stage IV disease. With the development of targeted therapies for advanced NSCLC, it has become important to understand which patients are being treated with systemic therapies and to what benefit.
a9ded1e5ce5d75814730bb4caaf49419 Method
We conducted a longitudinal, population-level study to determine the treatment patterns and survival in patients with stage IV NSCLC in Ontario, Canada between April 1, 2010 and March 31, 2015 from the Ontario Cancer Registry (OCR). Individuals were further identified as having non-squamous disease, and those who received an EGFR-TKI (afatinib, erlotinib, gefitinib) were assumed to be EGFR mutation-positive (EGFR+). Survival was calculated from date of diagnosis to death.
4c3880bb027f159e801041b1021e88e8 Result
24,729 individuals were diagnosed with NSCLC. Approximately half (12,159; 49.2%) had stage IV disease, including 10,103 with non-squamous disease, of whom 508 were categorized as EGFR+. The mean age for the stage IV non-squamous and EGFR+ cohorts were 68.7±11.0 years and 69.1±10.4 years, respectively; 49.3% and 60.8% were female, respectively. The most frequent treatments for stage IV non-squamous patients were palliative radiotherapy (RT) (46.7%) and systemic therapy (14.9%). Patients received no treatment in 26.7% of cases. 75.6% of the EGFR+ cohort received gefitinib, with the majority receiving no subsequent treatment (44.6%). Of EGFR+ patients receiving a second-line treatment, 20.1% received palliative RT and 18.7% received chemotherapy. Mean and median survival times (IQR) for the stage IV non-squamous patients were 0.9±0.0 years and 0.4 (0.2-1.0) years, respectively. Substantial variation in survival was noted by treatment (Figure 1). Mean and median survival times (IQR) for the EGFR+ cohort were 1.9±0.1 years and 1.5 (0.9-3.0) years, respectively.
Figure 1. Kaplan-Meier survival curves for stage IV non-squamous NSCLC patients based on treatment
8eea62084ca7e541d918e823422bd82e Conclusion
Relatively few patients with stage IV non-squamous NSCLC receive any systemic therapy. Survival is generally very poor, but best in the subgroup of EGFR+ patients.
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