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Nieves Alonso



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    EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.16-18 - EGFR Mutation Positive Non-Small Cell Lung Cancer: Management Approach and Survival Outcomes from the Hospital of Leon (Now Available) (ID 2613)

      08:00 - 18:00  |  Author(s): Nieves Alonso

      • Abstract
      • Slides

      Background

      Approximately 10-16% of non-small cell lung cancer (NSCLC) cases have the EGFR mutation. Studies have shown that EGFR tyrosine kinase inhibitors (TKIs) significantly prolong progression-free survival (PFS) in patients with advanced NSCLC in comparison to those treated with platinum-based chemotherapy doublets.

      Our aim is to perform a real world analysis of patients treated with TKI as first line therapy at the Hospital of Leon (CAULE).

      Method

      We retrospectively reviewed a total of 74 patients diagnosed with EGFR mutation positive NSCLC between March 2011 to June 2018 in the CAULE. Data was obtained from their medical records. The impact of comorbidities and smoking status on the survival rate were evaluated, in addition to the PFS and overall survival (OS) outcomes in patients treated with first line TKI. The follow-up schedule for computed tomography (CT) imaging was realized every 8 to 12 weeks.

      Result

      A total of 74 patients were included in the study, out of which 55 were treated with a first line TKI. Exon 19 deletion was the most prevalent mutation subtype accounting for 53% of cases. 67% of patients were women. The average age was 69 years old. 44% had metastasis to more than 2 sites at the time of diagnosis; 6 patients had brain metastasis, 4 of which received prior whole brain radiotherapy, 1 surgical treatment, and 1 didn’t receive local treatment.

      22% of patients had no medical comorbidities (including cardiovascular, pulmonary, neurological or psychiatric history). Results revealed that the presence of comorbidities had no statistical significance when analyzing its impact on survival outcomes (HR=0.85, 95%CI 0.37-1.83 p=0.64). Similar results were obtained when non-smokers (71%) were compared to smokers or former smokers, suggesting that smoking had no statistical significance when analyzing survival data (HR=0,94 95%CI: 0.43- 2.02 p=0.87).

      50% (n= 28) of patients were treated with first line gefitinib, 32% (n=18) with erlotinib and 10% (n= 6) with afatinib. There was no statistical significance in survival rates amongst patients treated with gefitinib vs afatinib or erlotinib (HR=1.6 P=0.56 95%CI 0.84-3.2).

      When analyzing best response to treatment, 63% of patient had a partial response, 20% demonstrated stable disease and 10% had progression of disease.

      Median OS was 31 months (95%CI: 20,5-31,4 months) and the PFS was 17 months (95%IC 13,9-20,6 months). 30% were alive at the time of analysis. The main cause of death was disease progression.

      Conclusion

      This real-world analysis of the data gathered from the Hospital of Leon confirms that treatment with TKI is beneficial for patients diagnosed with EGFR mutation positive NSCLC. In fact, our OS outcomes are similar than those reported in clinical trials.

      We have not observed significant differences amongst TKI treatment options, nor was there an impact on global survival rates in patients with underlying medical comorbidities.

      Given the prevalence of EGFR mutation positive lung cancer, more clinical data is required in order to expand scientific evidence and determine the best driver mutation therapy option based on patient’s profile.

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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-41 - EGFR Mutation Positive Non-Small Cell Lung Cancer: Management Approach and Survival Outcomes from the Hospital of Leon (ID 3139)

      10:15 - 18:15  |  Author(s): Nieves Alonso

      • Abstract

      Background

      Approximately 10-16% of non-small cell lung cancer (NSCLC) cases have the EGFR mutation. Studies have shown that EGFR tyrosine kinase inhibitors (TKIs) significantly prolong progression-free survival (PFS) in patients with advanced NSCLC in comparison to those treated with platinum-based chemotherapy doublets.

      Our aim is to perform a real world analysis of patients treated with TKI as first line therapy at the Hospital of Leon (CAULE).

      Method

      We retrospectively reviewed a total of 74 patients diagnosed with EGFR mutation positive NSCLC between March 2011 to June 2018 in the CAULE. Data was obtained from their medical records. The impact of comorbidities and smoking status on the survival rate were evaluated, in addition to the PFS and overall survival (OS) outcomes in patients treated with first line TKI. The follow-up schedule for computed tomography (CT) imaging was realized every 8 to 12 weeks.

      Result

      A total of 74 patients were included in the study, out of which 55 were treated with a first line TKI. Exon 19 deletion was the most prevalent mutation subtype accounting for 53% of cases. 67% of patients were women. The average age was 69 years old. 44% had metastasis to more than 2 sites at the time of diagnosis; 6 patients had brain metastasis, 4 of which received prior whole brain radiotherapy, 1 surgical treatment, and 1 didn’t receive local treatment.

      22% of patients had no medical comorbidities (including cardiovascular, pulmonary, neurological or psychiatric history). Results revealed that the presence of comorbidities had no statistical significance when analyzing its impact on survival outcomes (HR=0.85, 95%CI 0.37-1.83 p=0.64). Similar results were obtained when non-smokers (71%) were compared to smokers or former smokers, suggesting that smoking had no statistical significance when analyzing survival data (HR=0,94 95%CI: 0.43- 2.02 p=0.87).

      50% (n= 28) of patients were treated with first line gefitinib, 32% (n=18) with erlotinib and 10% (n= 6) with afatinib. There was no statistical significance in survival rates amongst patients treated with gefitinib vs afatinib or erlotinib (HR=1.6 P=0.56 95%CI 0.84-3.2).

      When analyzing best response to treatment, 63% of patient had a partial response, 20% demonstrated stable disease and 10% had progression of disease.

      Median OS was 31 months (95%CI: 20,5-31,4 months) and the PFS was 17 months (95%IC 13,9-20,6 months). 30% were alive at the time of analysis. The main cause of death was disease progression.

      Conclusion

      This real-world analysis of the data gathered from the Hospital of Leon confirms that treatment with TKI is beneficial for patients diagnosed with EGFR mutation positive NSCLC. In fact, our OS outcomes are similar than those reported in clinical trials.

      We have not observed significant differences amongst TKI treatment options, nor was there an impact on global survival rates in patients with underlying medical comorbidities.

      Given the prevalence of EGFR mutation positive lung cancer, more clinical data is required in order to expand scientific evidence and determine the best driver mutation therapy option based on patient’s profile.