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Michael Snee

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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      44P - Temporal trends in treatment (Tx) and overall survival (OS) among patients (pts) with incident NSCLC in the UK: A real-oncology database analysis from the I-O Optimise initiative (ID 514)

      12:30 - 13:00  |  Presenting Author(s): Michael Snee

      • Abstract
      • Slides


      As part of I-O Optimise, a multinational research platform providing real-world insights into the management of lung cancers, temporal trends for initial Tx and OS are reported for pts diagnosed with NSCLC at Leeds Teaching Hospitals Trust (LTHT), hosting one of the largest integrated cancer centres in the UK.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      A retrospective cohort study using longitudinal data collected from electronic medical records at LTHT, including all adult pts diagnosed with NSCLC from Jan 2007 to Aug 2017 (follow-up to Mar 2018). Initial Tx was the 1st Tx received after diagnosis (categorised as surgery, radiotherapy or systemic anti-cancer therapy [SACT]). In this analysis, 2 diagnostic periods were compared: 2007–2012 and 2013–2017. Kaplan–Meier methods were used for OS.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Among 3739 pts with incident NSCLC, TNM stage distribution was: I, 19.2% (this increased noticeably from 14.0% in 2007–2012 to 24.8% in 2013–2017); II, 11.6%; IIIA, 12.5%; IIIB, 9.0%; and IV, 47.7%. Overall, 29.7% had non-squamous cell carcinoma (NSQ), 21.9% had squamous cell carcinoma (SQ), 11.7% had NSCLC NOS (this decreased noticeably from 18.8% in 2007 to 8.4% in 2016) and 2.4% had other histology; 34.3% of pts were diagnosed without pathology. Tx patterns for NSQ and SQ pts are shown by stage and year of diagnosis (Table). Between 2007–2012 and 2013–2017, median OS (in months) increased noticeably in stage I–IIIA NSQ (28.7 to 50.0) and SQ pts (17.4 to 32.1), but not in stage IIIB–IV NSQ (4.1 to 5.0) or SQ pts (5.3 to 4.8)

      Temporal changes in initial Tx (within 6 months of diagnosis) by pathology, TNM stage and year of diagnosis*
      Stage IStage IIStage IIIAStage IIIBStage IV
      NSQn = 64n = 159n = 61n = 51n = 51n = 57n = 49n = 40n = 296n = 281
      Treatment (%)
      Surgery alone56.367.341.037.313.712.
      Surgery + SACT/RTMM21.321.69.817.50.00.0MM
      RT alone29.722.613.
      SACT + RT0.00.09.8M21.633.324.530.016.217.1
      SACT aloneMMMM13.714.024.537.522.031.0
      Untreated (%)
      SQn = 58n = 69n = 58n = 74n = 91n = 72n = 68n = 49n = 161n = 118
      Treatment (%)
      Surgery alone43.162.329.329.715.411.10.00.0MM
      Surgery + SACT/RTMM10.317.6MM0.00.0MM
      RT alone39.733.341.429.741.833.336.832.724.226.3
      SACT + RTM0.0M10.824.231.936.832.726.720.3
      SACT aloneM0.00.0MM11.111.814.316.821.2
      Untreated (%)MM13.810.813.28.314.718.429.227.1

      Data for patients with only clinical diagnosis and patients with initial treatment >6 months after diagnosis are not shown.

      M, masked as < 5 patients; RT, radiotherapy.


      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      OS improved in stage I–IIIA pts over time, most likely due to an increased proportion diagnosed at stage I and the evolution of initial Tx through the study period. In contrast, among stage IIIB–IV pts, SACT use remains relatively low and OS outcomes remain unchanged. Future analyses will help assess the impact of new therapies, including immunotherapy and 2nd-generation tyrosine kinase inhibitors, on Tx patterns and OS in the UK.

      b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement

      Editorial assistance was provided by Richard Daniel, PhD, of Parexel and funded by Bristol-Myers Squibb.

      934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study

      Bristol-Myers Squibb.

      213f68309caaa4ccc14d5f99789640ad Funding

      Bristol-Myers Squibb through an EU wide RWD initiative called IO-Optimize sponsored by BMS.

      682889d0a1d3b50267a69346a750433d Disclosure

      M. Snee: Grants, personal fees: IQVIA, during the conduct of the study. L. Lacoin: Consultant epidemiologist contracted by Bristol-Myers Squibb. W. Sopwith: Personal fees: IQVIA, during the conduct of the study and outside the submitted work. C. Chaib: Employee: Bristol-Myers Squibb; Bristol-Myers Squibb (BMS) is funding this work through an EU wide RWD initiative called IO-Optimize sponsored by BMS. J.R. Penrod: Employment, stock ownership: Bristol-Myers-Squibb. J.C. O’Donnell: Employee, shareholder: BMS. All other authors have declared no conflicts of interest.


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