Author of

• 12592

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  P3.10 - Poster Session 3 - Chemotherapy (ID 210)

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

  • 12646

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    P3.10-054 - Metastatic NSCLC Outcomes at a Single Canadian Institution Over a Decade (ID 3415)

    09:30 - 09:30  |  Author(s): D. Morris
    • Abstract

    Background
    In the past 10 years, the standard of care in non small cell lung cancer has seen the adoption of several less toxic and better tolerated therapies, allowing a greater proportion of metastatic patients the opportunity to receive 2[nd] and even 3[rd] line treatment. We investigated whether this improvement in the number of available therapies for metastatic NSCLC had any bearing on overall patient survival, by retrospectively analyzing patients diagnosed in 1999/2000, 2004/2005 and 2009/2010 at our centre.

    Methods
    After ethical approval was obtained demographic details, clinical variables and outcome data were gathered retrospectively via chart review, on NSCLC patients diagnosed at the Tom Baker Cancer Centre (TBCC) in 1999/2000, 2004/2005 and 2009/2010 (Glans-Look Lung Cancer Database). All patients were restaged according to the new 7th Edition of the American Joint Committee on Cancer TNM system for NSCLC staging. Stage IV patients and early stage patients with subsequent metastatic recurrence were included in the analysis. Survival was analyzed using the Kaplan-Meier method and differences measured by a log rank test.

    Results
    1290 patients were included in the preliminary analysis (data only from 1999, 2004/2005 and 2009/2010), 1018 of which were stage IV at diagnosis, 272 who recurred with metastatic disease. The median overall survival (MOS) of patients increased slightly from 1999 to 2009/2010, from 4.5 months in 1999, to 5.7 months in 2004/2005 to 4.6 months in 2009/2010, as did the proportion of patients who received systemic treatment (21.3% in 1999, 28.9% in 2004/2005 and 28.1% in 2009/2010). However, the proportion of patients who received 2 or more lines of chemo doubled from 1999 to 2009/2010 (7.3% in 1999, 12.1% in 2004/2005 and 14.6% in 2009/2010)(p = 0.04). In addition, there was a trend towards increasing median overall survival (MOS) of systemically treated patients over 1999-2009, from 9.6 months (95% CI: 7.6-11.6) in 1999 to 12.7 months (95%CI: 11.0-14.4) in 2009/2010 (p=0.25).

    Conclusion
    Our analysis suggests that there are an increasing proportion of metastatic NSCLC patients being treated systemically at our centre, specifically, the proportion being treated with two or more lines of systemic therapy has significantly increased over the decade from 1999-2009/2010. This study also suggests a trend toward an increased MOS for systemically treated patients diagnosed in 2009/2010 compared to those diagnosed in 1999. However, the vast majority of patients (>3/4) are still not being treated with systemic therapy, despite the increase in available therapies now compared to a decade ago. The reasons for this are not clear but may include poor ECOG performance status, rapid decline, sub-optimal referral pathways and rural residence. Further analyses will be presented.