Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

C. Chouaid



Author of

  • +

    MA03 - Epidemiology, Risk Factors and Screening (ID 374)

    • Event: WCLC 2016
    • Type: Mini Oral Session
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
    • +

      MA03.06 - Cost Effectiveness of Chest Scan Screeing for Lung Cancer in Abestos Occupational Exposure Subjects: A Model Based Study (ID 5037)

      14:56 - 15:02  |  Author(s): C. Chouaid

      • Abstract
      • Presentation
      • Slides

      Background:
      The National Lung Screening trial (NLST) showed that screening with low-dose computed tomography (CT) compared with chest radiography reduced lung-cancer mortality. There is very few data's on subjects with occupational abestos exposure. We examined the cost-effectiveness of CT lung cancer screening in a french cohort of abestos post professional exposure subjets (APEXS cohort).

      Methods:
      We estimated mean lif-years, costs and incremental cost-effectiveness ration (ICER) for screening with low-dose CT compare to no screening in this population of abestose exposed subjects. Estimations of life-years gained were based on the efficacy of NLST trial aplpied to APEXS cohort, adjusted to sex and age. Costs were limited to directs costs, from the payer perspective. We also performed sensitiviy analysis based on several assumptions of screening program efficacy.

      Results:
      Compared with no screening, screening with low-dose CT, over a period of 2 years, will cost, for 1000 subjects of APEXS cohort 312 645 €, will provide 9.4 additional life-years. The corresponding ICER was 33 102 € per life-gained. Sensitiviyt analysis showed that this result is sensitive to screening program efficacy (number, stage, and survival diagnosed by the program).

      Conclusion:
      ICER of low-dose CT lung cancer program in a cohort of abestos post occupational exposure population appears as acceptable from the French health system.

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P1.01 - Poster Session with Presenters Present (ID 453)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
    • +

      P1.01-036 - Lung Cancer Screening Program Is Cost Effective in French Setting: A Model Based Study (ID 5054)

      14:30 - 14:30  |  Author(s): C. Chouaid

      • Abstract

      Background:
      The National Lung Screening Trial (NLST) showed that screening with low-dose computed tomography (CT) as compared with chest radiography reduced lung cancer-mortality. There is no data's on the faisability and cost-effectiveness of CT lung cancer screening program in the French setting.

      Methods:
      We estimated mena life-years gaineds, costs and incremental cost-effectiveness ratio (ICER) for screening with low-dose CT compare to no screening. Estimations of life-years gained were based on the efficacy of NLST trail applied to the general french population using the same inclusion criteria's that NLST trail (age of 55 to 74 years with a minimum of 30 pack-years of smoking and no more than 15 years since quitting) adjusted to sex, age and smoking status. Costs were limited to directs costs from the payers perspective. We also performed sensitivity analysis based on several asssumptions of program efficacy.

      Results:
      The target population was 5 551 141 subjects. Compared with no screening, screening with low-dose CT, over a period of 2 years, will have an additional cost of 941 978 €, will provide 52.4 additional year of life with a corresponding ICER of 17 969 € per year gained. Sensititiviy analysis showed that this result is sensitive to program efficacy (number, stage and survival of lung cancer diagnosed by the program) and to subjects compliance rate to the program.

      Conclusion:
      Cost effectiveness of CT lung cancer screening program in a French population using the same main inclusion criteria and outcomes of NLST trial appears as acceptable from the french health system

  • +

    P3.02c - Poster Session with Presenters Present (ID 472)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
    • +

      P3.02c-089 - ImmunoCHIC: A Prospective Nivolumab Monotherapy Cohort in Advanced Non-Small Cell Lung Cancer Patients in Routine Clinical Practice  (ID 5839)

      14:30 - 14:30  |  Author(s): C. Chouaid

      • Abstract

      Background:
      in France, in May 2015, Nivolumab early access program was established for patients with advanced NSCLC progressing during or after platinum-based chemotherapy. There is little evidence of Nivolumab use out of clinical trials. We report here one year of Nivolumab use in a French Universitary hospital.

      Methods:
      Observational prospective review of patients with advanced NSCLC treated with Nivolumab monotherapy (3 mg/kg/2weeks) in our center, in routine clinical practice. Patients in clinical trial were excluded. Analyze was done on clinico-pathological features, tolerance and outcomes.

      Results:
      63 patients were included (men: 76.1%, age: 65 (range: 40–78), squamous: 33.3%; smoker: 93.7%%, EGFR/ALK negatives: 98.4%, unknown PDL1: 70%; at least one significant comorbidity: 54%; performans status 0/1/2: 34%/49%/17%; cerebral metastasis: 38%; nivolumab as second, third and more than third lines: 38%/38%/24%. Median number of nivolumab cycles: 6 (1-24), more than 12 cycles: 20.6% Disease control rate : 59% (3 complete responses) ; Clinically significant adverse event: 13 (20%) patients (asthenia: 4 patients, grade 2 to 4 colitis: 3 patients, pneumoniae: 3 patients, nephritis: 1 patient). After Nivolumab, 50% of the patients received an another systemic therapy. Two patients were able to go back to work.

      Conclusion:
      In real life setting, nivolumab had the efficacy level reported by pivotal clinical trial but with a higher rate of clinically significant adverse events, particularly colitis.

  • +

    P3.03 - Poster Session with Presenters Present (ID 473)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
    • Presentations: 1
    • +

      P3.03-061 - Burden of Disease and Managment of Mesothelioma in France: A National Cohort Analysis (ID 5072)

      14:30 - 14:30  |  Author(s): C. Chouaid

      • Abstract

      Background:
      Malignant pleural mesothelioma (MPM) is an uncommon cancer with poor survival. The aim of this study was to determine the burden of MPM disease in France and analyze associations between socio-economic deprivation, population density, management and outcomes of MPM.

      Methods:
      We used a national hospital data base (PMSI-MCO) to extracted MPM incidents patients of years 2011 and 2012 (ICD-10 codes C45.0 and C54.9 as principal/related or significantly associated diagnosis (PD,RD, SAD) in 2011 and 2012, without MPM codes or C34/C38.4 codes as PD/RD/SAD since 2006). Patients were followed for two years after the initial diagnosis. Cox models were used to analysis one and two-years survival according to sex, age, comorbidities, management, a population density index (PDI) and a social deprivation index (SDI) based on census data aggregated at the municipalities level.

      Results:
      1890 patients were included on the analysis (men: 76%, age: 73.6 ± 10 years, significant comorbidities: 84%). Patients lived in urban zones in 57% cases and in hight deprivated areas in 53%. Only 1% had a curative surgical procedure; 65% received at leat one dose of chemotherapy (72% at least one administration of chemotherapy with pemetrexed, 28% at least one administration with pemetrexed - bevacizumab); 42% and 20% of the patient received chemotherapy on the last three and the last months of their life, respectively); Survival rate at one- and two-year were 64% and 48% respectively. In multi-variate analysis men, older, patients with chronic renale failure, patients with chronic respiratory failure and patients who didn't receive pemetrexed at any time of their management had worse pronostic. Adjusting analysis on age, gender, comorbidities (hypertension, diabetisi, COPD), leaving in rural/semi rural area was associated with a better survival at one and two-year, HR: 0.82 (0.72-0.96) and HR: 0.83 (0.73-0.94); social deprivation index was not a significant variable for survival. The mean cost management per patient was 27 624 ± (15894 ) euros (31.4% of this cost was the cost of pemetrexed and bevacizumab).

      Conclusion:
      MPM remained an uncommon disease, with less of 1000 new cases a year in France, with a very poor pronostic and a significant burden for National Health system.