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Dimas Yusuf
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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: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.15-34 - Treatment Patterns and Outcomes of Stage III Non-Small Cell Lung Cancer (NSCLC): Real World Evidence of How our Patients Fare (ID 14011)
16:45 - 18:00 | Presenting Author(s): Dimas Yusuf
- Abstract
Background
Most patients withstage III non-small cell lung cancer (NSCLC) develop metastases and succumb to their cancer. New treatment strategies, including concurrent chemo–RT (cCRT) followed by adjuvant immunotherapy, are improving outcomes, but need to be contextualized with real world data. In this study, we described population-based treatment patterns and outcomes for stage III NSCLC in a large Canadian province.
a9ded1e5ce5d75814730bb4caaf49419 Method
Through the provincial cancer registry, patients diagnosed with stage III NSCLC from April 1st 2010 to March 31st 2015 were identified. Using electronic medical records and administrative claims, stage III patients were merged with treatment and survival information. Patient characteristics, treatment patterns, and outcomes were analyzed.
4c3880bb027f159e801041b1021e88e8 Result
6,438 patients were diagnosed with NSCLC, including 1,151 (17.9%) with stage III disease. Median age at diagnosis was 70 years (22–94); 50.2% were male. The majority were stage IIIA (61.2%); the remainder was stage IIIB (36.4%) or unspecified (2.4%). Most patients received palliative RT (32.8%), supportive care until progression (24.8%), or palliative chemotherapy (14.8%) as initial treatments. Relatively few underwent cCRT (11.7%) or trimodality therapy (1.7%). Resection was performed on 14.8% of patients. Within the resected cohort, the majority (47.6%) did not receive further perioperative treatment, while others had surgery as part of trimodality (11.2%) or alongside perioperative chemotherapy (37.1%). Overall, the median OS (mOS) was 13.3 months (0–NR). Initial treatment strategy predicted outcomes (p< 0.05). Patients who underwent cCRT had mOS of 23.8 months (1.1–not reached [NR]). mOS for patients who initially received palliative chemotherapy or RT was 11.1 months (0.3–NR), and 6.2 (0–NR) with supportive care (Figure 1).
Figure 1: Kaplan–Meier curves for stage III NSCLC stratified by treatment class
8eea62084ca7e541d918e823422bd82e Conclusion
Treatment rates for cCRT and trimodality therapy in our cohort appear lower than expected despite evidence supporting the benefits of these strategies. Use of other treatment options was associated with poorer outcomes.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)
- 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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P3.15-30 - Treatment Patterns and Survival of Patients with Stage IV Non-Small Cell Lung Cancer (NSCLC) in the Era of Novel Therapies (ID 14042)
12:00 - 13:30 | Presenting Author(s): Dimas Yusuf
- Abstract
Background
Treatment strategies for metastatic non-small cell lung cancer (NSCLC) are evolving rapidly. Real–world evidence (RWE) of treatment patterns and outcomes can further our understanding of the impact of novel therapies. In this population-based study, we investigated treatments and outcomes for stage IV NSCLC in a large Canadian province.
a9ded1e5ce5d75814730bb4caaf49419 Method
Patients diagnosed with de novostage IV NSCLC from April 1st2010 to March 31st2015 were identified. Baseline characteristics, treatments, and outcomes were analyzed. We classified treatments targeting EGFR, EML4–ALK, and ROS1 as targeted therapy and intravenous checkpoint inhibitors as immunotherapy.
4c3880bb027f159e801041b1021e88e8 Result
A total of 6,438 patients were identified with NSCLC, of whom 3,606 (56%) had de novostage IV disease. The median age of diagnosis was 69 years (range 20–100) and 52.4% were male. The median age among those who received targeted therapy and immunotherapy were 63 (27–90) and 61 (37–72) years, respectively, and 41.8% and 61.8% were male, respectively. First line treatments were: 5.7% targeted agents (n= 204), 1% immunotherapy (n = 1), 19.5% palliative chemotherapy (n= 703), 6.8% palliative radiotherapy (n= 246), and 74.8% received supportive care only (n= 2,698). Most frequent subsequent treatments in 2L included: 30.7% targeted agents (n= 125), 1.7% immunotherapies (n= 7), 67.6% palliative chemotherapy (n= 275), 32.2% palliative radiotherapy (n= 131). Median overall survival (mOS) for the whole cohort was 3.8 months (0–not reached [NR]). MOS with targeted therapies was 18 months (1.4–NR), chemotherapy was 9.4 months (1.1–NR) and supportive care only had a mOS of 2.5 months (0–NR) (Figure 1). About 1.0% of patients (n= 34) received immunotherapy at any line.
8eea62084ca7e541d918e823422bd82e Conclusion
Survival benefit was dependent on type of treatment received, with a trend towards improved survival with newer agents.
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