Author of

• 31680

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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
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31713

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    P2.16-30 - Real World Data of Targeted Therapy Versus Chemotherapy Maintenance Among Patients with III-IV Clinical Stage Lung Cancer at Oncosalud – AUNA (ID 2853)

    10:15 - 18:15  |  Author(s): Carlos Vallejos
    • Abstract

    Background
    

    Lung cancer is still a prevalent and fatal neoplasm in developing countries where newer therapies usually had issues about economic toxicity and real clinical benefit in terms of overall survival. In the last decades, chemotherapy maintenance has occupy an important role in the treatment, as well as targeted therapies (tirosin kinase inhibitors and bevacizumab) in the frontline treatment. Our aim was to evaluate the survival impact of targeted therapy in advanced lung cancer at a private Peruvian institution (Oncosalud – AUNA).

    Method
    

    We analyzed retrospectively data of two cohort of patients with advanced NSCLC (III-IV clinical stage) treated at Oncosalud-AUNA during the period 2008 - 2013 (Lima, Peru). The clinical-pathological data were collected from digital medical records. After a clinical response obtained with a standard regimen based on chemotherapy (≥ stable disease), all patients were distributed in two groups. Group 1 received only maintenance chemotherapy and group 2 had maintenance with targeted therapy, either erlotinib or bevacizumab. OS was determinate using Kaplan-Meier method and survival curves comparison were performed using log-rank or Breslow test. Cox model was used for multivariate analysis.

    Result
    

    During the study period 58 cases were included, 30 and 28 cases were distributed in group 1 and 2, respectively. The median age was 65 years (range: 44-85) and male:female ratio was 1:1, less than 16% had ≥2 ECOG scale, and about two thirds were diagnosed as CS IV. No statistically difference was found between both two groups. More than 60% of patients received at least six cycles platins based chemotherapy, only five cases reached complete response (8%), partial response was 47% and stable disease 45%. In the group 2, 46% received combined treatment based on bevacizumab and 54% erlotinib as maintenance therapy. Progression rates were 87 and 86% in groups 1 and 2, respectively. The median follow-up was 3 years, median PFS were 10 months for group 1 and 17 months for group 2, and 2-years PFS rates were 17 versus 30%, respectively (p=0.008). Median OS were longer in the group with targeted therapy (3.7 versus 1.4 years, p=0.014). In multivariate analysis the use of targeted therapy (PFS: HR:0.47, 95% CI[0.26,0.85], p=0.013 and OS: HR:0.36, 95% CI[0.18, 0.74], p=0.005) and age <60 years (PFS: HR:0.41, 95% CI[0.19,0.9], p=0.027 and OS: HR:0.30, 95% CI[0.12, 0.73], p=0.008) were associated to better outcomes.

    Conclusion
    

    An important clinical benefit in terms of survival was obtained with the addition of targeted therapy to the standard of care in the treatment of lung cancer in our cohort.