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Robin Munro



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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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      45P - Treatment (Tx) patterns and overall survival (OS) in patients (pts) with stage IIIB–IV NSCLC in Portugal: An IPO-PORTO database analysis from the I-O Optimise initiative (ID 210)

      12:30 - 13:00  |  Author(s): Robin Munro

      • Abstract
      • Slides

      Background

      Understanding Tx patterns and related outcomes in the rapidly changing NSCLC landscape informs clinical decision-making. As part of I-O Optimise, a multinational research platform providing real-world insights into the management of lung cancers, Tx patterns and OS are reported for pts with NSCLC prior to immunotherapy reimbursement in Portugal.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      IPO-Porto, Portugal’s largest oncology hospital, has a research database linked to the RORENO cancer registry, covering northern Portugal. This database has collected data on 1524 adult pts with NSCLC since 2012; the current analysis includes pts diagnosed at stage IIIB–IV from Jan 2015 (when systemic anticancer therapy [SACT] data became available) to Dec 2016 (follow-up to Jun 2017). Tx patterns are shown for the first 3 Tx lines. Kaplan–Meier methods were used for OS and time to next Tx or death (TTNT) from SACT initiation.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Of 595 pts diagnosed at stages I–IV in 2015–2016, 54 (9.1%) had stage IIIB and 338 (56.8%) had stage IV NSCLC (median age, 65 yrs [range: 27–90; 9.2% ≥80]; male, 77.3%; brain metastases, 16.3%; non-squamous [NSQ], 73.7%; squamous [SQ], 21.2%). Of the 372 NSQ/SQ pts, 284 (76.3%) had 1st-line SACT; 101 (27.2%) had 2nd-line, and 20 (5.4%) had 3rd-line (Table). Median OS from SACT initiation was 12.6 (NSQ) or 10.3 (SQ) months. Median OS was longer in stage IV pts without brain metastases (11.6 vs 7.6 months), and in treated NSQ pts with EGFR/ALK alterations vs wild type (14.4 vs 9.3 months). Most NSQ pts with EGFR/ALK alterations (73.0%) had a 1st-line tyrosine kinase inhibitor (TKI). Median TTNT was 11.0 months in NSQ pts on 1st-line TKI and 6.3 (NSQ) or 7.3 (SQ) months in pts on 1st-line platinum chemotherapy

      SACT regimen (%)Non-squamousSquamous
      1st-line Txn = 221n = 63
      Platinum-based chemotherapy72.987.3
      Non-platinum single agent4.512.7
      TKI (any)22.60.0
      Erlotinib12.70.0
      Crizotinib2.30.0
      Gefitinib7.70.0
      Anti-PD-1/anti-PD-L1 checkpoint inhibitors0.00.0
      2nd-line Txn = 82n = 19
      Platinum-based chemotherapy13.421.1
      Non-platinum single agent59.873.7
      TKI (any)24.40.0
      Erlotinib9.80.0
      Crizotinib11.00.0
      Other TKI3.60.0
      Anti-PD-1/anti-PD-L1 checkpoint inhibitors2.45.3
      3rd-line Txn = 17n = 3
      Platinum-based chemotherapy35.30.0
      Non-platinum single agent41.2100.0
      TKI (any)11.80.0
      Erlotinib5.90.0
      Crizotinib0.00.0
      Anti-PD-1/anti-PD-L1 checkpoint inhibitors11.80.0

      PD-1, programmed death-1; PD-L1, programmed death-ligand 1

      .

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Pts with advanced NSCLC have a high burden of disease, with most diagnosed at stage IV and a short OS from SACT initiation. Future analyses will assess the post-reimbursement impact of immunotherapies (and new TKIs) on Tx and OS in Portugal.

      b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement

      Professional medical writing 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.A.S. Soares: Advisory boards, talks: Roche; Lilly, BMS, MSD; Boehringer Ingelheim, Pfizer, AstraZeneca, Novartis, outsider the submitted work. L. Antunes, P. Redondo, M.J. Bento: Grants: IQVIA, during the conduct of the study. M. Borges: Grants: IQVIA to IPO Porto, during the conduct of the study. R. Hermans, F. Grimson, R. Munro: Employee: IQVIA Real-World Insight Solutions (vendor paid by BMS). D. Patel: Personal fees: BMS, during the conduct of the study. C. Chaib: Employee: Bristol-Myers Squibb. L. Lacoin: Consultant epidemiologist contracted by Bristol-Myers-Squibb. All other authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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