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Maria Fernanda Medeiros
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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: 2
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P09.09 - Overall Survival in Elderly Metastatic Non-Small Cell Lung Cancer Patients Treated with Immune Checkpoint Blockade (ID 3483)
00:00 - 00:00 | Author(s): Maria Fernanda Medeiros
- Abstract
Introduction
Lung cancer is the leading cause of cancer death. Despite the high frequency of lung cancer among the elderly (patients ≥65 years-old), this population is underrepresented in clinical trials, including, though to a lesser extent, those investigating immunotherapy. The objective of this study was to describe the clinical-pathological profile of metastatic Non-Small Cell Lung Cancer (NSCLC) patients treated with immune checkpoint blockade (ICB) and analyze the overall survival (OS) according to age. We also compared the OS of metastatic elderly patients treated or not with ICB.
Methods
This was a retrospective cohort that included all metastatic NSCLC patients, diagnosed from August 1999 to December 2019, treated with ICB or other therapies at A. C. Camargo Cancer Center, São Paulo, Brazil. Demographics and clinical-pathological data were collected from electronic medical records. The variables evaluated were age, gender, race, smoking status, Charlson score, ECOG, histology, presence of EGFR or ALK driver mutations, number of metastasis sites and number of treatment lines. OS for patients treated with ICB as first, second or third line of therapy was evaluated according to age: ≥65 years-old (elderly) or <65 years-old (young patients). We used descriptive statistics (median and frequencies) to characterize the population. Frequencies were compared by Pearson’s Chi-squared or Fisher’s exact test. OS was defined as the time between the date of diagnosis to the date of death by any cause. Kaplan-Meyer method was used to estimate survival curves. Survival between groups was compared by the log-rank test. Tests with p<0.05 were considered statistically significant.
Results
Among the 81 patients that used ICB, 40.7% were ≥65yo, 54.3% were men, 79.1% were white and 54.3% were former smokers. 34.6% of all patients had a Charlson’s comorbidity score 7 or 8. 75.3% had ECOG 0-1 and 71.6% had adenocarcinomas. 44% had EGFR mutations or ALK rearrangements, 49.4% had 1 to 2 metastatic sites and 58.9% received up to 3 treatment lines. Clinical characteristics distribution among 471 patients not treated with ICB were similar to that observed in the population treated with ICB, except for the frequency of EGFR mutations and ALK rearrangements (65.6%), of patients with 1 to 2 metastatic sites (66.8%), and of patients who received up to 3 treatment lines (80.9%). At a median follow-up of 38.7 months for the population who used ICB, median OS was 29,5 months (95%CI 18.29-40.77). Median OS was 29.63 months for the elderly versus 28.87 months for the young patients (p=0.92). No difference was observed using 70yo as a cutoff, as well (p=0.63). For comparison, OS among elderly patients who were not treated with ICB was 21.22 months.
Conclusion
The elderly seems to derive the same benefit from ICB as younger patients. OS among elderly patients that received ICB was longer than among those who were not treated with ICB.
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P09.41 - Body Mass Index (BMI) Is Associated With Overall Survival in Patients With Metastatic Non-Small Cell Lung Cancer (ID 2268)
00:00 - 00:00 | Presenting Author(s): Maria Fernanda Medeiros
- Abstract
Introduction
Obesity is related to increased mortality in several types of tumors, including endometrium, postmenopausal breast cancer and bladder. Contradictorily, for lung cancer there seems to be an inverse relationship, and patients with higher body mass index (BMI), obese or overweight, have improved survival.
BMI is the ratio between the weight in kilograms and the height in meters squared and is commonly used as surrogate for body composition. Using the BMI, obesity is defined as a BMI ≥30 Kg/m2, of overweight as a BMI between 25 and 29,9 Kg/m², normal weight as a BMI from 18,5 to 24,9 Kg/m² and underweight below 18,5 Kg/m2.
The objective of this study was to analyze the BMI of the patients with Non-Small Cell Lung Cancer (NSCLC) and to investigate its impact on overall survival.
Methods
We conducted a retrospective analysis of patients diagnosed with metastatic non-small cell lung cancer diagnosed between 2000 and 2019, at AC Camargo Cancer Center, Brazil. Demographics, clinical-pathological characteristics, treatment patterns and outcomes data were obtained from electronic medical records.
We collected weight and height information to calculate the BMI. Other variables such as ECOG, Charlson’s comorbidity score, histological subtype, smoking load and number of metastasis were also analyzed. Overall survival was defined as the time between diagnosis and death by any cause. We used descriptive statistics to characterize the study population. Association between BMI and other variables was tested with Pearson’s Chi-Squared or Fisher’s exact tests. The Kaplan-Meyer method was used to estimate survival. Impact of BMI on survival was calculated with Cox regression method. P-values <0.05 were considered statistically significant.
Results
We analyzed data from 456 patients with metastatic NSCLC. About 52,9% were men, 73,9% were white, 21,9% were smokers, 42,1% were former smokers and 32,2% non-smokers. Most of the patients had adenocarcinoma (78,5%). 63,2% of patients had ≥2 sites of metastasis. Median Charlson’s score was 8 and 46,7% had ECOG 1.
Median BMI was 24,3 kg/m2 (13,0-50,8). Patients were dichotomized into two groups based on the median BMI: <24,3 (89,7%) and ≥ 24,3 (10,3%).
At a median follow up of 41,5 months, the median overall survival of the group who had lower BMI was 15,8 months versus 24,3 months in the group with higher BMI (HR=1,56; 95% IC 1,0-2,3; P-value=0,034).
Conclusion
According to our data, there is an inverse relation between BMI and risk of death in patients with metastatic NSCLC. Patients who had lower BMI had a worse overall survival. BMI is associated with survival and should be considered as a prognostic factor in patients with lung cancer.
