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Matthew Thompson



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    P2.12 - Small Cell Lung Cancer/NET (ID 180)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.12-01 - Small Cell Lung Cancer (SCLC) Treatment and Survival in the UK: A REAL-Oncology Analysis from the I-O Optimise Initiative (ID 1724)

      10:15 - 18:15  |  Author(s): Matthew Thompson

      • Abstract
      • Slides

      Background

      Outcomes for patients with extensive disease (ED) SCLC are poor. Treatment options have remained mostly unchanged for several decades. As part of I-O Optimise, a multinational research platform providing insights into the real-world management of lung cancers, clinical characteristics and outcomes of patients with ED-SCLC at Leeds Cancer Centre, UK, are presented.

      Method

      This retrospective cohort study used longitudinal data collected from electronic medical records of adult patients diagnosed with ED-SCLC between January 2007 and August 2017 (follow-up to December 2018). ED was defined as stage IV disease at diagnosis or, where staging was missing, by clinical review using the Veterans Administration Lung Cancer Study Group (VALSG) system. Patients with a concomitant malignant primary tumour or missing data for age or sex were excluded. Distinct lines of therapy (LoTs) were identified using a clinically verified algorithm based on name and date of systemic anti-cancer therapy (SACT) prescribed. Overall survival (OS) was determined using Kaplan–Meier methods.

      Result

      Of 5834 patients diagnosed with lung cancer during the study period, 695 (11.9%) had SCLC. Of 655 patients remaining after study exclusions, 425 (64.9%) had ED-SCLC. Where complete years of data were available (20072016), there was a decrease in the proportion of ED-SCLC diagnoses (from 76.3% to 60.0%). Among patients with ED-SCLC, median age was 69 years (range: 6275) and 50.4% were male; 31.3% had a World Health Organization performance score (PS) of 01, 23.8% had PS2, 21.9% had PS3, and 7.3% had PS4. In total, 272 patients (64.0%) received SACT. Annual rates of treatment were similar between 2007 and 2016. Proportions treated were highest in patients with PS0–1 (87.2%) and lowest in those with PS4 (9.7%). Almost all treated patients (96.7%, n=263) received platinum-based SACT as first LoT; 47 patients (17.3% of treated patients) received a second LoT. Median OS (Q1Q3) for patients with ED-SCLC receiving SACT was 7.2 months (4.310.5) versus 0.7 months (0.31.6) for those not receiving SACT. Median OS was similar for treated patients with PS0–1 and PS2 (7.4 and 7.2 months, respectively).

      Conclusion

      In line with other real-world studies, outcomes for patients presenting with ED-SCLC are poor, especially if untreated. Levels of treatment have not improved over the past decade. Availability of new immune checkpoint inhibitors may provide improved survival for some patients, but additional approaches are urgently needed.

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