Author of

• 11692

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  P2.10 - Poster Session 2 - Chemotherapy (ID 207)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11707

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    P2.10-015 - Less toxic chemotherapy improves uptake of all lines of chemotherapy in advanced non small cell lung cancer, particularly in the elderly: A ten year retrospective population-based review (ID 1066)

    09:30 - 09:30  |  Author(s): K. Ramsden
    • Abstract

    Background
    The platinum doublet is standard first-line therapy in advanced NSCLC. Over the past decade, well tolerated second-line therapies have been approved including erlotinib and pemetrexed. We hypothesize that the introduction of less toxic chemotherapy has increased treatment of advanced NSCLC resulting in improved survival.

    Methods
    The BC Cancer Agency provides cancer care to a population of 4.5 million. A retrospective review was conducted of all referred Stage IIIB/IV patients in four 1 yr time cohorts; C1 baseline (1998) and 6 months after the provincial approval of C2 docetaxel (2001), C3 erlotinib (2006) and C4 pemetrexed (2007).

    Results
    2, 623 patients were referred and 720 had systemic therapy. Characteristics: M/F 55%/45%, median age 67 (33-101), ECOG <=1/>=2/unknown 33%/56%/11%, never/former/current/unknown smoker 9%/35%/36%/20%, squam/nonsquam/NOS 18%/41%/41%. More patients received first line chemotherapy over time; 16%, 23%, 34%, 33% C1-4 respectively. In C1 to C4 uptake of second line (21%, 27%, 38%, 55%) and third line (10%, 10% 14%, 18%) increased. In C1 the most common first line doublet was cis/vino (70%) and in C4, cis/gem (45%). Second line doce was frequently used in C2 (51%) but usage decreased in C4 to 7% vs. erlo 50% and pem 26%. In the >=70 group (n=1118), 1[st] line usage increased from C1 9% to C4 19% and 2[nd]line in the C2 (doce) 4% to C4 (erlo+pem avail) 56%. The increased use of systemic therapy was associated with improved survival in all patients: C1 4.56 m vs C4 4.98 m (p=0.004) and treated patients; C1 9.48 m vs C4 12.07 m (p=0.014) and the >= 70 group; C1 9.7 m vs C4 12.5 m (p=0.07).

    Conclusion
    This population-based data set represents the trend of treatments over time in a large geographical area, including community and tertiary care cancer treatment sites. The introduction of less toxic systemic therapy for advanced NSCLC resulted in an increased proportion of patients treated with first-line chemotherapy and an even greater increase in 2nd/3rd line treatment. This trend was particularly evident in the elderly. Associated with this was a significant improvement in overall survival for all subsets.