Author of

• 15209

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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)

  • 15257

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    P3.01-048 - Predictors of Subsequent Lines of Therapy (LOTs) in Non-Small Cell Lung Cancer (NSCLC) (ID 781)

    09:30 - 09:30  |  Author(s): J.L. Espirito
    • Abstract

    Background:
    In recent years, the number of NSCLC treatment options has increased. The majority of patients receiving first-line therapy (1L) for locally advanced or metastatic NSCLC progress; however, fewer than half receive subsequent treatment. This analysis investigated which factors might be predictive of patients receiving subsequent LOTs within a US community network.
    
    Methods:
    A retrospective data analysis was conducted using electronic health records in the US Oncology Network for adult patients with advanced NSCLC receiving second-line therapy from 3/1/10 to 12/31/12, with follow-up through 10/31/14. Patients receiving 1L tyrosine kinase inhibitors (EGFR/ALK+), with concurrent cancer diagnoses, or in a clinical trial were excluded. Data on monotherapy/combination treatments, LOT, staging, histology, ECOG performance status (PS), metastases, comorbidities, age, gender, geography and practice size were collected. Chi-square tests examined patient and disease factors related to the receipt of subsequent treatments (2L–3L and 3L–4L). Logistic regression was used to predict the likelihood of receiving a subsequent LOT in multivariate models. Overall survival (OS) was estimated from diagnosis and from the initiation of each LOT.
    
    Results:
    Of 2,122 patients receiving 2L treatment, 963 (45%) advanced to receive 3L and 319 (15%) advanced to receive ≥4L treatment. Median age at 2L was 67 years (range, 34–94); 58% were male. PS at 2L was available for 80% of patients; 8%, 68%, and 24% were PS 0, 1, or 2+, respectively. The histology breakdown was 54% non-squamous, 25% squamous, and 21% not-specified. In univariate analysis, significance (P<0.05) for receiving a 3L/4L+ therapy was found for age, PS, histology, and treatment type. Multivariate analysis results are presented (Table). Figure 1 Of patients receiving 2+ LOTs, median OS from advanced NSCLC diagnosis was 22 months (95% CI: 20, 23). Median OS from the start of 2L, 3L, and 4L was 8.9, 7.0, and 7.2 months, respectively. In 2L, median OS for patients who received a 3L compared to those who did not was 13.4 vs 5.0 months (P<0.0001); median OS in 3L for patients who received a 4L compared to those who did not was 12.9 vs 4.9 months (P<0.0001).
    
    
    
    Conclusion:
    Receiving subsequent LOTs is associated with improved OS in advanced NSCLC. Whether this represents the efficacy of therapeutic agents or an enrichment for patients capable of receiving additional therapy is unclear. Nonetheless, these data on patient and treatment predictive factors may assist in understanding how future treatments might allow more patients to advance to later LOTs.