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S. Elsamany
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-062 - Impact of Gender on Survival Outcome in Saudi Patients with Advanced Non-Small Cell Lung Cancer (ID 563)
09:30 - 09:30 | Author(s): S. Elsamany
- Abstract
Background:
Different prognostic variables have been proposed in non-small cell lung cancer (NSCLC). The present study aims to evaluate the prognostic value of patients’ gender in Saudi patients with advanced non-squamous NSCLC.
Methods:
In this retrospective study, patients with stage IIIB-IV non-squamous NSCLC, from 3 institutes in Saudi Arabia, were included. We examined the distribution of patients and treatment characteristics at diagnosis according to the gender.These categorical variables were compared using Chi-square test. Overall survival (OS) was assessed according to the gender in addition to age categories (≤ 60 vs. > 60 years), ECOG performance status (PS) (0-2 vs. 3-4), type of 1st line chemotherapy (pemetrexed containing vs. others) and EGFR status. Differences in survival distributions were evaluated via Log Rank test. Multivariate analysis by Cox proportional hazard model has been used to check for independent prognostic factors associated with OS.
Results:
One hundred and twenty patients were included (100 stage IV, 20 stage IIIB, 92 males, 28 females). Eighty patients had available results of EGFR testing and 26.2% of them were mutant. EGFR mutations were more common among female patients (45.4% vs.18.9%, p=0.023). Only half of EGFR-mutant patients received 1[st] line erlotinib, while the other half received erlotinib as a maintenance or 2[nd] line therapy due to delayed EGFR testing results. No difference in the distribution of other parameters according to the gender including age, PS, site (bone vs. others) and number of metastasis (single vs. multiple), type of 1[st] line therapy and number of cycles of chemotherapy. After a median follow up of 22 months (range 15-31 months), greater proportion of females were alive compared to males (60.7% vs. 23.9% respectively, p<0.0001). In univariate analysis, OS was improved in female patients (female; 23.0 months, 95% CI= 17.03-28.97 vs. male; 8.7 months, 95% CI= 5.16-12.24, p < 0.0001), PS 0-2 (PS 0-2;14.4 months, 95% CI= 10.66-18.14 vs. PS 3-4; 2.0 months, 95% CI= 0.50-4.99, p < 0.0001), those with pemetrexed-containing chemotherapy (pemetrexed-containing; 17.0 months, 95% CI=12.87-21.13 vs. others; 11.0 months, 95% CI=5.90-16.10, p= 0.019) and EGFR- mutant patients (mutant; 23.0 months, 95% CI=16.41-27.39 vs. wild;11.7 months, 95% CI=8.24-15.16, p=0.006). In multivariate analysis, mutant EGFR status (HR=2.49, 95% CI=1.19-5.19, p=0.015) and female gender (HR=2.78, 95% CI= 1.30-5.95, p=0.008) were independent predictors of improved OS.
Conclusion:
Female Saudi patients with advanced non-squamous NSCLC have better survival outcome irrespective of their EGFR status. Low frequency of smoking habit among Saudi females may explain this outcome.
