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O. Chirita
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P1.06 - Poster Session with Presenters Present (ID 458)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.06-032 - The Humanistic Burden of Advanced Non-Small Cell Lung Cancer Patients in Europe - A Real World Survey (ID 5654)
14:30 - 14:30 | Author(s): O. Chirita
- Abstract
Background:
Previous publications have demonstrated that advanced Non-Small Cell Lung Cancer (aNSCLC) patients have worse HRQoL compared to the general population. Few publications have focused on the impact of aNSCLC on activities of daily living and the humanistic burden incurred by different groups of aNSCLC patients in the real world setting.
Methods:
Data were taken from a multi-center, cross-sectional study of aNSCLC patients conducted in France, Germany and Italy. The study consisted of three components: medical chart review, patient questionnaire and caregiver questionnaire. Overall, 683 consulting patients were recruited via treating physicians. Patients’ health state was quantified using the EuroQoL-5D (EQ-5D-3L - comprising of five domains: mobility, self-care, ability to perform usual activities, pain, anxiety and depression) and the burden on HRQoL quantified using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), a 30 item questionnaire yielding five functional scales, three symptom scales, a global health status/QoL scale, and six single items. Analysis was stratified by patients’ line of therapy. Statistical significance was assessed using Mann-Whitney U tests.
Results:
Patients’ mean (SD) age was 65.2 (9.7), 68.8% were male and 89.0% had stage IV NSCLC. Over two-thirds (71%) of patients were receiving 1st line advanced therapy, whilst 29% were receiving later lines of therapy. Regarding histology, 74% of patients were non-squamous compared to 26% squamous. The mean EQ-5D-3L index for 2[nd] line or later patients was significantly lower compared to patients on 1[st] line treatment (0.57 vs 0.65; p=0.002). Three domains showed significant decreases: mobility, self-care and ability to perform usual activities. In terms of EORTC scores, patients on later lines of treatment experienced a lower overall global health status (QL2) compared to 1[st] line patients (43.8 vs 50.7; p<0.001). Significant differences were also observed in all other EORTC scales except for diarrhoea.
Conclusion:
1[st] line aNSCLC patients have a diminished health state in comparison to the general population (EQ-5D scores 0.65 v 0.78). In addition compared to other cancer sufferers, aNSCLC patients have a worse QoL (QLQ-C-30 QL2 score 48.8 v 61.5 for stage IIIB/IV cancer patients). The real world study shows that both health status and QoL significantly worsen with advancement to later lines of treatment. The results show a high unmet need for more effective 1[st]–line treatments to prevent disease progression while maintaining patient quality of life.
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P1.06-041 - Overall Survival and Intermediate Outcomes among Scandinavian Non-Small Cell Lung Cancer Patients: The SCAN-LEAF Study (ID 5141)
14:30 - 14:30 | Author(s): O. Chirita
- Abstract
Background:
The past decade has seen several advances in the field of non-small cell lung cancer (NSCLC), with improved tools for tumor characterization as well as novel targeted and immune therapies. It is important to understand the current treatment landscape including treatment outcomes, in order to maximize patient benefits from these advances. SCAN-LEAF is a Scandinavian retrospective cohort study with prospective annual data cuts, providing a unique opportunity for insights into real-world clinical NSCLC practice over more than a decade. It includes clinical practice patterns of tissue biopsy, pathological diagnosis and tumor biomarker status testing, and their relationship to treatment choices and outcomes. Here, we present intermediate and survival outcomes by disease stage and histology subtype, and factors associated with survival.
Methods:
SCAN-LEAF consists of a registry-based cohort including all diagnosed NSCLC patients in Denmark, Norway and Sweden (Cohort 1), and a Swedish sub-cohort (Cohort 2) supplemented with data from electronic medical records (EMRs). Based on the first data collection including data from NSCLC patients diagnosed 2005-2013, overall survival (OS; Cohort 1 & 2) and progression-free survival (PFS; Cohort 2) will be estimated using Kaplan-Meier analysis and reported as cumulative incidences (with 95% CI) by disease stage at diagnosis, histological subtype, biomarker status, presence of metastases, age and gender. Response rates (Cohort 2) will be described by treatment line in addition to stage and histology subtype. Association of stage with survival (Cohort 1 & 2) and treatment response (Cohort 2) will be analyzed by Cox regression with time to event (death or response) as outcome variable and disease stage category at diagnosis, follow-up time, and therapy line as stratification variables. In addition, the relationship between OS and intermediate outcomes, as well as predictors of OS (e.g. smoking and biomarker status, lesion location, metastasis at diagnosis), will be explored by Cox regression (Cohort 2).
Results:
Intermediate and survival outcomes for Scandinavian NSCLC patients diagnosed between 2005 and 2013, as well as any association between overall survival and factors such as patient characteristics and treatment patterns, will be presented.
Conclusion:
The SCAN-LEAF study, expected to include >115,000 Scandinavian NSCLC patients and >2,000 sub-cohort patients diagnosed between 2005 and 2018 during the full duration of the study, will give valuable insights into current care, changing treatment patterns and patient outcomes in a real-world setting. A better understanding of factors associated with survival and intermediate outcomes among NSCLC patients will inform clinical decision-making.
