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Jerzy Tyczynski



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    PD01 - Poster Discussion Session (ID 4)

    • Event: NACLC 2019
    • Type: Poster Discussion Session
    • Track:
    • Presentations: 2
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      PD01.08 - Incidence and Predictors Associated With the Development of Peripheral Neuropathy in Non-small Cell Lung Cancer Patients (ID 51)

      15:45 - 16:45  |  Presenting Author(s): Jerzy Tyczynski

      • Abstract

      Background:
      Recommended chemotherapy for unresectable locally advanced or metastatic non-small cell lung cancer (NSCLC) includes platinum agents, taxanes and immunotherapy agents. However, these treatments have been associated with the development of peripheral neuropathy (PN). We present the incidence rates of PN and identify its predictors using a real-world data source.


      Method:
      In Optum’s Humedica electronic health records database, we identified NSCLC patients diagnosed between 1/1/2008 and 12/31/2017, using a combination of ICD-9/ICD-10 diagnosis codes and structured data derived from physician notes. Patients with lung surgery or other primary cancers in the 12 months prior to diagnosis were excluded. Distinct lines of treatment (LOT) were established using business rules, and incidence rates of PN for each LOT were calculated. We identified predictors of PN development any time after treatment start by carrying out a stepwise Cox regression analysis using 27 covariates.


      Results:
      Of the identified 63,174 NSCLC patients, 26,061 had LOT 1, 9,938 had LOT 2, and 4,790 had LOT 3. Incidence rates for all patients, and those with and without a history of PN and diabetes for LOTs 1-3 and across all LOTs of a patient are shown in Table 1. Of the 27 covariates in the Cox regression, age?65 (HR: 0.94; p=0.0083), male gender (HR: 1.12; p<0.0001), Asian race (HR: 0.72, p=0.0034), squamous cell histology (HR: 1.13; p0.0001), a history of peripheral neuropathy (HR: 2.86; p 0.0001), and a history of diabetes (HR: 1.37; p 0.0001)were found to be significant predictors f developing PN. table1_pn.jpg


      Conclusion:
      Of all treated NSCLC patients, more than a quarter develop PN over the course of their treatments. Incidence rates increase with each LOT indicating an increased risk as patients continue treatment. Identifying covariates associated with PN allows identification of high-risk patients, which may contribute to lowering the risk of developing PN.

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      PD01.09 - Incidence and Predictors Associated with the Development of Pneumonitis in Non-small Cell Lung Cancer Patients. (ID 53)

      15:45 - 16:45  |  Presenting Author(s): Jerzy Tyczynski

      • Abstract

      Background:
      Pneumonitis (Pn) is a known side effect of non-small cell lung cancer treatments that include chemotherapy, radiation, immunotherapy and targeted therapies. The development of Pn may require cessation of therapy. We present the incidence rates of Pn and identify its predictors, by line of treatment, using a real-world data source.


      Method:
      In Optum’s Humedica electronic health records database, we identified NSCLC patients diagnosed between 1/1/2008 and 12/31/2017, using a combination of ICD-9/ICD-10 diagnosis codes and structured data derived from physician notes. Patients with lung surgery or other primary cancers in the 12 months prior to diagnosis were excluded. Distinct lines of treatment (LOT) were established using business rules, and incidence rates of Pn for each LOT were calculated. We identified predictors of Pn development any time after treatment start by carrying out a stepwise Cox regression analysis using 27 covariates.


      Results:
      Of the 63,174 NSCLC patients that were identified, 26,061 had LOT1, 9,938 had LOT2, and 4,790 had LOT3. Incidence rates for all patients, and those with and without a history of Pn for LOTs 1-3 and across all LOTs of a patient are shown in Table 1. Of the 27 covariates in the Cox regression, male gender (HR: 1.19; p<0.0001), squamous cell histology (HR: 1.38; p0) (HR: 1.08; p=0.008), a history of pneumonitis (HR: 2.39; p0.0001), and a history of diabetes (HR: 1.09; p=0.007) were ound to be significant predictors of developing Pn. table1_pneumonitis.jpg


      Conclusion:
      Of all treated NSCLC patients, more than 20% develop Pn over the course of their treatments, and ~15% in any one LOT. Prior history of pneumonitis significantly increases the risk of developing the disease during treatment. Physicians may appropriately tailor treatments and care of patients affected by the identified predictors of Pn.