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M.M. Daumont
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P1.06 - Poster Session with Presenters Present (ID 458)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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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): M.M. Daumont
- 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.
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-097 - Prognostic Factors for Overall Survival among Patients with Advanced/Metastatic Non-Small Cell Lung Cancer (NSCLC) (ID 4582)
14:30 - 14:30 | Author(s): M.M. Daumont
- Abstract
Background:
The LENS (Leading the Evaluation of Non-squamous and Squamous NSCLC) retrospective medical chart review was undertaken to describe characteristics, treatment patterns and outcomes among patients receiving systemic treatment for advanced/metastatic NSCLC in Europe. This analysis reports on prognostic factors associated with overall survival (OS) from start of first line treatment (1L).
Methods:
Patients with NSCLC stage IIIb/IV diagnosis between July 2009 and August 2011 were sampled from oncology/pulmonology practices in France, Germany, Italy, and Spain. Patients were followed to their most recent visit (data collected October 2013 to April 2014). Data were extracted from medical charts. Prognostic factors associated with OS from start of 1L were examined through Cox proportional hazard estimation. Independent clinically relevant variables included age, gender, tumor histology, and TNM disease stage. Additionally, variables for presence of metastases, prior administration of mutation (EGFR, ALK, KRAS) tests, surgery, and health insurance type were included. A backwards selection process (model 1) was applied to select the variables from the latter group with a significance level of 0.1. The remaining variables were entered into a second model 2 with all clinically relevant variables regardless of their significance. The final model 3 included all clinically relevant variables plus the significant variables from model 2.
Results:Significant Prognostic Factors for OS from Start of 1L (p<.05) in Final Multivariable Model
The analysis included data from 736 1L patients from 168 sites in the four countries, who were followed for a mean of 1.7 years (range: 22 days – 4.6 years) until the most recent visit (28.9%) or death (71.1%).Variable (Reference) Level Hazard Ratio (95%CI) P-Value Age Category at first diagnosis (<65 ) >79 2.6 (1.9-3.7) <.0001 Country (Germany) Spain 1.6 (1.2-2.0) <.0001 TNM disease stage (IIIB) IV 1.6 (1.2-2.1) <.0001 ECOG Score (0) 1 2+ 1.5 (1.2-1.9) 2.8 (2.1-3.7) <.0001 <.0001 Smoking (Never) Current Former 2.3 (1.7-3.2) 1.6 (1.2-2.1) <.0001 .005 Malignant Pleural Effusion (No) Yes 1.3 (1.0-1.5) .037 Any Mutation Testing Conducted (No) Yes 0.74 (0.6-0.91) .004 EGFR+ Mutation Test (Negative, Not Tested, Inconclusive) Yes 0.75 (0.6-0.97) .027 Surgery (No) Yes 0.36 (0.2-0.6) <.0001
Conclusion:
This rich multi-country clinical dataset provides insight into real world patient clinical, demographic, and treatment characteristics prognostic for OS. The results indicate survival worsened for patients who were older, with higher ECOG scores, TNM stage IV, and smokers. Prior surgery and EGFR testing were associated with improved survival. OS was not associated with insurance plan type.
