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Harish Kancharla



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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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      P3.01-51 - Outcomes with Systemic Chemotherapy in Advanced  NSCLC Patients with Performance Status 2 and Above and without Driver Mutation (ID 14433)

      12:00 - 13:30  |  Presenting Author(s): Harish Kancharla

      • Abstract
      • Slides

      Background

      Platinum-based combination chemotherapy is recommended as the standard treatment for patients with advanced NSCLC, but its benefit is limited to patients with performance status (PS) of 0 or 1. However, it is not clear whether these benefits apply to patients with poor performance status ((PS 2 and above)). These patients have inferior outcomes and have been excluded from clinical trials. This population accounts for a significant portion (up to 30%) of patients of our practice and some of them have been treated with systemic chemotherapy based on clinician’s discretion. We have analyzed the outcome of these patients who have been treated with chemotherapy despite poor performance status.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We performed a retrospective analysis of patients of advanced NSCLC with poor PS (ECOG PS 2 or more) registered at our lung cancer clinic between January 2016 and September 2017 and treated with systemic chemotherapy. Patients with driver mutations who were treated with first line TKIs were excluded. Hospital case records were reviewed for baseline characteristics, treatment details and outcome data.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 78 patients were found to be eligible for this analysis. Median age was 60 years (33-77 years) including 15% patients 70 years or above. At presentation out of these 78 patients, 48 (62.5%) were smokers, 24 patients (30 %) had pleural effusion, 8 patients (10%) had brain metastasis and 30 patients (38%) had bone metastasis. Majority patients had ECOG PS 2 but 35 % had PS 3 or 4 also and 38(48 %) had one or more associated comorbidities. The most common chemotherapy regimen used was weekly paclitaxel and carboplatin (50 %) followed by pemetrexed and carboplatin (23 %). Majority (61.5 %) patients could complete 4 or more cycles of chemotherapy however 10 patients (13%) could receive only one cycle and 21 (27%) patients even received maintenance chemotherapy. Chemotherapy was interrupted or stopped due to toxicity in 33% patients. At least one point improvement in ECOG PS from baseline was observed in 44 patients (56%) after 2 cycles of chemotherapy. Objective response and disease control rates were 21 % and 48.6 % respectively. After a median follows up of 8.6 months, median progression free survival was 5.8 months.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Systemic chemotherapy in modified doses and schedules in advanced NSCLC patients with PS 2 and above is feasible and may be associated with better symptom palliation with clinical benefit and improvement in survival. Further studies addressing this neglected subgroup are indicated.

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