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Vinicius Lorandi

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    MA24 - Initiatives to Improve Health in Lung Cancer Patients (ID 354)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Advocacy
    • Presentations: 1
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      MA24.10 - Estimation of Deaths Due to Lack of Access to Immunotherapy for Brazilian Patients Diagnosed with Advanced NSCLC Without Any Driver Mutation (ID 2967)

      14:30 - 16:00  |  Author(s): Vinicius Lorandi

      • Abstract
      • Slides


      Lung cancer is a major cause of cancer worldwide. Despite efforts to curtail risk factors such as tobacco consumption, it remains both common and lethal. More recently novel targeted therapies and the development of immunotherapy provided a substantial increase in the expected survival of patients diagnosed with advanced lung cancer. Nonetheless, the lack of access to these medications, especially in low and middle-income countries, is a trending concern.

      Brazil is considered to be a middle-income country and its citizens have access to a universal healthcare system (Sistema Único de Saúde – SUS) – fully funded by the government. Around 75% of the population rely exclusively on this public system when treating their diseases. Many high-cost drugs, such as immunotherapy and TKI’s, are not provided due to budget constraints.

      This study has the goal of estimating the impact in premature lives lost in the Brazilian population due to lack of access to the best currently available therapy for patients with advanced non-small cell lung cancer (NSCLC) without driver mutations.


      Firstly, we searched for data regarding the incidence of lung cancer in the Brazilian population using INCA’s (Brazilian National Cancer Institute) database, demographic data from the Brazilian Government and compiled staging and histologic data from different private and public oncologic centers. For analytic reasons, we compared the incidence data with the ones observed in the American Surveillance, Epidemiology, and End Results (SEER).

      Using survival data from the pivotal phase 3 studies for immunotherapy in NSCLC (PACIFIC, Keynote 189 and 407) we estimated the expected total number of patients alive one year after diagnosed with stage III or IV NSCLC (excluding those with driver mutations) considering they had received the best treatment available according to the NCCN guidelines. This number was compared with the expected survival for patients receiving the standard treatment in the Brazilian SUS (chemoradiation followed by observation for stage III NSCLC and palliative Carboplatin + Paclitaxel for stage IV NSCLC without driver mutations).


      After compiling all data of interest, we estimated that 2.332 premature deaths would occur in Brazilian patients with advanced NSCLC one year after diagnosis, exclusively due to lack of access to immunotherapy. Comparing Brazilian incidence data with the American data from SEER, this number may actually be underestimated and can reach up to 11.193 premature deaths in a single year.


      The lack of access to immunotherapy is a major concern for countries in development and this can lead to an enormous impact on survival of patients with lung cancer. Further studies are needed to best estimate the economic impact and provide data to help decide when to adopt new technologies and drugs to treat these patients. Strategies may rapidly be implemented in order to avoid further unnecessary premature deaths of NSCLC patients.

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