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Diego Lucas Kaen
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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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EP1.16-39 - Prospective Epidemiological Study of Metastatic Non-Small Cell Lung Cancer (NSCLC) in Latin America – LATINO Lung (LACOG 0116) (Now Available) (ID 1405)
08:00 - 18:00 | Author(s): Diego Lucas Kaen
- Abstract
Background
Non-small cell lung carcinoma (NSCLC) is the main cause of cancer-related death in Latin America. Nonetheless, there is insufficient information regarding its epidemiology, treatment and outcomes in the region. The goals of this study are to describe disease characteristics, treatment patterns and survival for advanced NSCLC in Latin America.
Method
LACOG 0116 LATINO Lung is a prospective cohort study aiming to include approximately 800 patients with advanced stage NSCLC (stage III/IV at diagnosis or distant relapse of early-stage disease) from 24 sites in Brazil, Argentina, Mexico, Colombia and Chile. All consecutive newly diagnosed patients seen at each site will be invited to participate. Data on socioeconomic and demographic characteristics, medical/oncologic history and clinical-pathological characteristics will be collected at baseline. Thereafter, patients will be followed every 6 months for 3 years in order to gather information regarding treatment patterns and sequencing, reasons for treatment discontinuation, response to treatment, disease progression and overall survival. Data will be collected during medical visits or telephone calls and by medical charts review. Primary endpoint is to estimate the overall survival. Descriptive analysis of treatments and outcomes are planned. Multivariable regression methods will be applied to assess possible independent prognostic or predictive factors.
Result
As of April 3rd, 2019, 107 patients have been included, all of them within 16 sites in Brazil. Currently, there are 2 sites from Argentina, 2 from Mexico, 3 from Colombia and 1 from Chile awaiting regulatory approval to begin enrollment. Recruitment is planned to last until December 2019, when the estimated sample size will be achieved.
Conclusion
LACOG 0116 LATINO Lung is the first Latin American lung cancer prospective cohort study that will generate real-world data on NSCLC. The study may identify gaps and inequities in a diverse population of NSCLC in Latin America and consequently raise the need for improvement and individualized approach of lung cancer care in the region.
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-15 - Survival and Clinical Immunotherapy Outcomes in Hispanic Patients vs Non-Hispanic White Patients with Non-Small Cell Lung Cancer (Now Available) (ID 1514)
10:15 - 18:15 | Author(s): Diego Lucas Kaen
- Abstract
Background
The number of Hispanic (HISP) patients (pts) enrolled in immunotherapy (IMMUNO) trials is minimal or non-existent in non-small cell lung cancer (NSCLC). It’s well known that HISP pts with NSCLC have not only a different genomic profile than Non-Hispanic Whites (NHW)- like higher expression of EGFR mutations- but also better outcomes than NHW (“Hispanic Paradox”); thus the need to validate outcomes in HISP pts treated with IMMUNO.
Method
We present data in 436 NSCLC pts treated with IMMUNO at 5 large institutions (3 in the US, 2 in Latin America). The agents evaluated include: nivolumab, pembrolizumab and atezolizumab. 256 pts were HISP and 180 pts were NHW. Most of the pts were treated with single agent therapy as second line or beyond while a small group of pts were treated as first line. The primary endpoints of the study were: response rate (ORR), progression free survival (PFS) and overall survival (OS). Secondary endpoints were disease control rate (DCR), PD-L1 expression and others.
Result
The results are consolidated in the table below.
Hispanics (n=256)
NHW (n=180)
p value
Sex (males)
52%
45%
0.2059
ORR
First Line
35%
30%
0.6590
Second Line
18%
19%
0.3236
Adeno
22%
24%
0.6714
SQCC
24%
23%
1.0000
PDL1 (+)
29%
32%
0.4839
PDL1 (-)
5%
17%
0.3040
Disease Control Rate: ORR+SD (DCR)
Adeno
68%
67%
0.8989
SQCC
67%
46%
0.0777
Median PFS
4m
4m
0.7509
Median OS
22m
22m
0.2004
There were no statistical significant differences among HISP and NHW pts regarding ORR, DCR, PFS, OS, and responses according to PD-L1 status.
Conclusion
No significant differences were found in the clinical outcomes between these 2 ethnic groups despite the “Hispanic Paradox” and expected genomic differences; however pts with actionable mutations were excluded as they usually do not get IMMUNO as first or second line; an approach that might change after IMPOWER 150. This is the largest comparison of NSCLC immunotherapy outcomes in HISP vs NHW pts. These results are comparable to the ones seen in Checkmate and Keynote studies. As expected, higher response rates were seen in first line therapy and pts with PD-L1 (+) status. Further comparisons will be better addressed by a larger prospective study.
