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Ariadna Juarez-Garcia



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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: 2
    • 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): Ariadna Juarez-Garcia

      • 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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      P2.12-19 - Small Cell Lung Cancer (SCLC) Treatment and Survival in Portugal: An IPO-PORTO Analysis from the I-O Optimise Initiative (ID 1762)

      10:15 - 18:15  |  Author(s): Ariadna Juarez-Garcia

      • Abstract

      Background

      Approximately 15% of lung cancers are SCLC, which is an aggressive disease associated with poor patient outcomes and limited treatment options. As part of I-O Optimise, a multinational research platform providing insights into the real-world management of thoracic malignancies, the IPO-PORTO study aimed to characterise treatment options and their impact on overall survival (OS) in patients diagnosed with SCLC in Portugal’s largest oncology hospital.

      Method

      IPO-PORTO collects data on patients with various cancers and is linked to the North Region Cancer Registry (RORENO), covering Northern Portugal. This analysis included all adult patients diagnosed with non-resected limited disease (LD)- or incident extensive disease (ED)-SCLC at IPO-PORTO between January 2012 and June 2017, with follow-up to December 2017. ED was defined as metastatic because Veterans Administration Lung Study Group staging was not available. Systemic anti-cancer therapy (SACT) information was available from 2015 onwards. Bespoke and clinically validated rule-based algorithms were applied to describe treatment patterns. The Kaplan–Meier method was used to estimate OS.

      Result

      Of 227 patients diagnosed with incident SCLC, 61 (26.9%) had non-resected LD and 166 (73.1%) had ED. Median age was 65 years (range: 59–72) and most patients (83.7%) were male. Most patients with LD-SCLC had stage IIIA/IIIB disease (78.7%). Sites of metastasis in ED-SCLC were bone (47.6%), liver (45.2%), lymph nodes (17.5%), or brain/CNS (13.3%). In patients diagnosed with LD-SCLC from 2015 onwards, 16 of 25 (64.0%) received SACT; among these, 11 received SACT associated with radiotherapy (68.8%). In patients diagnosed with ED-SCLC from 2015 onwards, 53 of 83 (63.9%) were treated with SACT. Among the 69 patients treated with SACT after diagnosis, only 9 received 2nd-line treatment (13.0%). Almost all patients received a platinum-based regimen including cisplatin or carboplatin and etoposide as 1st-line treatment. In patients diagnosed from 2012 onwards, the 1-year OS rate was 54% (95% CI, 43–69) for patients with LD-SCLC and 17% (95% CI, 12–24) for ED-SCLC. Among treated patients with ED-SCLC who were diagnosed from 2015 onwards, the 1-year OS rate was 18% (95% CI, 9–35).

      Conclusion

      Patients with SCLC had a high disease burden; most patients were diagnosed with ED and nearly three-quarters died within a year of diagnosis. The study confirmed that the majority of ED-SCLC patients diagnosed at IPO-PORTO after 2015 were treated with SACT; despite this, 1-year OS rates remained low (<20%).