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Julia Roeper
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P08 - Early Stage/Localized Disease - Epidemiology (ID 117)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P08.07 - Clinical Characteristics and Treatment Patterns of NSCLC Stage III Patients from Real World (ID 1830)
00:00 - 00:00 | Presenting Author(s): Julia Roeper
- Abstract
Introduction
The prognosis of non-small cell lung carcinoma stage III depends on various factors. An optimal therapy of this frequent and prognostically important disease is of enormous importance. As a basis for the best possible therapy is the precise knowledge of the patient collective. So the aim of this study is to provide a precise overview of the patients population and it’s outcome from real world.
Methods
The data from the tumor documentation of the Pius Hospital were processed and evaluated. Data on age, sex, UICC stages, general condition, diagnosis, therapy and outcome from non-small cell stage III lung cancer patients, who have been diagnosed between 2011 and 2017, were evaluated. Regarding prognosis, established clinical outcomes were calculated. Overall survival, time to progression and progression free survival were estimated using the Kaplan-Meier method. The distribution of the first site of metastasis was described descriptively. The influence of patient characteristics on survival was calculated by Cox regression analysis.
Results
Non-small cell lung cancer stage III were diagnosed in 546 cases at Pius Hospital, Oldenburg during the observation period. Of these, 83% received a PET-CT, which is recommended in any case. The clinically comparatively early apparent squamous cell carcinoma accounts for the largest share with 47%. Patients under the age of 65 undergo a higher amount of therapies. In almost 6% of the cases, it was decided to limit the therapeutic steps to best supportive care. The median survival time of treated patients is 22 months in stage IIIA and 18 months in stage IIIB and IIIC. The survival time across stages is 20 months. Patients who have undergone surgery have an overall survival of 53 months. Progression Free Survival is 10 months and time to progression is 15 months in stage III. In patients who are not tumour-free after primary therapy, local progression is the most common type of progression. Metastases are often found in the lungs, brain, bones and adrenal glands.
Conclusion
This study gives a deep insight in patients characteristics, diagnostics, therapy modalities and outcome of patients with non-small cell lung carcinoma, who were treated at Pius-Hospital, Oldenburg during the observation period 2011 – 2017.
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P09 - Health Services Research/Health Economics - Real World Outcomes (ID 121)
- Event: WCLC 2020
- Type: Posters
- Track: Health Services Research/Health Economics
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P09.31 - Adherence to Treatment Recommendations from Multidisciplinary Tumor Boards (ID 1900)
00:00 - 00:00 | Presenting Author(s): Julia Roeper
- Abstract
Introduction
Due to the German National Cancer Plan, cancer centers have been established. Lung cancer centers are responsible for coordinating the care of lung cancer patients in a region and to diagnose and treat them according to the latest evidence-based knowledge. For this purpose, every patient should be discussed in a multidisciplinary tumor board. In the tumor board an individual treatment plan is discussed and treatment recommendations are given. Therefore, we investigate: 1.) how are the recommendations from tumor boards being adhered to; 2.) which factors determine the adherence of tumor board recommendations and 3.) what is the relationship between the adherence of tumor board recommendations and patient outcomes in terms of overall survival?
Methods
Data from 1784 newly-diagnosed patients with lung cancer discussed in tumor boards in one certified lung cancer center in Northern Germany between 2014 and 2018 were documented and evaluated according to the adherence to tumor board recommendations. A preliminary analysis of the first 109 cases analyzed will be presented. Data was analyzed descriptively.
Results
Median age of the 109 patients was 67 years (36-88 yrs) and 59% (n=64/109) of them were male. Most of the patients had an ECOG status of 0 or 1 (71%; n=77/109) and 79% of them were current or ex heavy smoker (n=86/109). 63% (n=69/109) of the patients that have been discussed in the multidisciplinary tumor board, were afterwards further treated at the same certified lung cancer center. In 78% (n=85/109) of patients, the treatment recommendations from the multidisciplinary tumor boards were completely adhered to. There were different reasons for non-adherence, e.g. patient’s wish, patient characteristics and death before starting therapy. The median overall survival for the 109 patients was 109 months. Patients with a complete adherence to the multidisciplinary tumor board recommendation had an overall survival of 17 months (n=84) compared to 7 months (n=13) for patients with a partial adherence compared to 1 months (n=11) for patients with a non-adherent treatment (p<0.000).
Conclusion
Preliminary results give a hint to the fact that patients with an adherent treatment after first diagnosis had a longer overall survival than patients with another therapy. More cases will be presented at the meeting using a multivariate analysis which includes patient characteristics and healthcare organizations that took over further treatment as predictors.
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P74 - Health Services Research/Health Economics - Real World Evidence (ID 246)
- Event: WCLC 2020
- Type: Posters
- Track: Health Services Research/Health Economics
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P74.02 - Treatment Patterns of EGFR mt+ NSCLC IV pts: Real World Data of the NOWEL Network (ID 1870)
00:00 - 00:00 | Presenting Author(s): Julia Roeper
- Abstract
Introduction
The percentage of pts switching from 1st gen TKI in 1st line to 3rd gen TKI in 2nd line seems to be low with 30% and it is questionable whether these data represent real world treatments. Therefore, we investigated the treatment pattern and especially the attrition rate between 1st and 2nd line therapy in EGFR mt+ pts.
Methods
965/1536 (63%) pts with non-squamous NSCLC IV were tested for EGFR mt+. 148/965 (15%) pts with an EGFR mt+ were identified. To calculate PFS and OS we used Kaplan Meier and the log rang test for p-values.
Results
Baseline characteristics of 148 EGFR mt+ pts: median age 65 yrs; 64% female (n=95/148); 64% never/light smoker (n=94/148). 135/148 pts (91%) carried an EGFR mt+ either del19 (n=81) or L858R (n=55). 144/148 pts were treated with TKI on 1st or 2nd line (after chemotherapy). 14/144 pts are still on 1st line, 9 pts were lost to follow-up and 3 pts died while on 1st line. We identified 118/144 candidates for 2nd line therapy (because of progression on 1st line TKI) and only 84/118 (70%) pts received a 2nd line therapy. 30% (36/118) of pts did not receive a 2nd line therapy because of bad PS (n=26), pts refusal (n=2), fast progression (n=6) and death (n=2). After accessibility of 3rd gen TKI 72 pts were candidates for 2nd line treatment and 51/71 pts (71%) received a 2nd line therapy. mOS of pts receiving 2nd line therapy after access to 3rd gen TKI was 35 mo for pts with 2nd line therapy vs. 10 mo without 2nd line (p<0.000). 32/51 pts (63%) were tested for T790M and 20/32 (62%) were T790M+. Highest T790M test rate in one center was 22/28 (79%). 16/20 (80%) T790M+ pts received 3rd gen TKI for 2nd line therapy. mOS of pts receiving 3rd gen TKI (n=31) was 51 mo vs. 25 mo for pts without 3rd gen TKI (p<0.002).
Conclusion
A significant number of pts treated with 1st or 2nd gen TKI do not reach 2nd line therapy even with broad accessibility of 3rd gen TKI. Reasons for not receiving 2nd line therapy are in most cases deterioration of PS, death and no testing for T790M in a minority of cases. These data are important for the interpretation of the OS data of the FLAURA study as they reflect real world treatment algorithms in dedicated German lung cancer centers.
