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A. Gonzalez-Ling
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P3.05 - Poster Session with Presenters Present (ID 475)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Palliative Care/Ethics
- Presentations: 2
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.05-002 - Malnutrition is an Independent Risk Factor on Survival on EGFR Mutated Patients Diagnosed with Non-Small Cell Lung Cancer (ID 5300)
14:30 - 14:30 | Author(s): A. Gonzalez-Ling
- Abstract
Background:
Lung cancer continues to be the leading cause of cancer-related death worldwide. In Mexico, EGFR mutation is around 31%. Malnutrition is a common problem among patients with cancer, affecting up to 85% of end-stage cancer patients, and 50-56% advanced NSCLC patients. Malnutrition poses an unfavorable prognosis and has also been associated with higher incidence of treatment related toxicity. No evidence about malnutrition in EGFR mutated patients has been described. The objective of the study is to asses the relation between malnutrition and survival of patients with NSCLC and EGFR mutation.
Methods:
One hundred-five patients diagnosed with NSCLC haring EGFR mutation undergoing any line of treatment were assessed from January 2015 to June 2016. Malnutrition was measured using the Subjective Global Assessment tool (SGA), patients were classified as without malnourishment (SGA=A) or malnourished (SGA=B+C). Overall survival was compared with the Kaplan-Meier method.
Results:
Baseline characteristics are shown in Table 1, 51.9% of patients were malnourished by the time of evaluation. Overall survival (OS) was 13.6 months (95% CI:12.7-14.4 months). Patients without malnutrition at the time of treatment initiation had a better OS than malnourished patients 14.2 vs 10.5 months (p=0.003) (Figure 1). Malnutrition is a risk factor for death independently of age, sex and treatment with TKIs versus chemotherapy (OR=8.7, 95% CI: 1.01-75.4, p=0.049).
Conclusion:
Patients harbouring EGFR mutations benefit from more effective treatments, and usually have better prognosis. Malnutrition is an independent risk factor for mortality in this population, thus assessment of nutritional status and a timely referral to a nutrition expert could result a better prognosis and health related quality of life.
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P3.05-003 - Anxiety and Depression in Patients with EGFR+ NSCLC Receiving Treatment with TKIs (ID 6152)
14:30 - 14:30 | Author(s): A. Gonzalez-Ling
- Abstract
Background:
Patients with lung cancer (LC) report higher levels of anxiety and depression than cancer patients in general. Targeted therapies, such as tyrosine kinase inhibitors (TKIs) offer patients with EGFR mutations improved survival outcomes with less associated toxicity. This type of treatment has been associated with improvement on quality of life and lower symptomatic burden, which influence emotional status. The aim of this study is to report anxiety and depression prevalence and severity on patients with EGFR mutation on the course of the first four months of treatment with TKIs.
Methods:
A cohort of 76 LC patients receiving TKIs was evaluated. Hospital Anxiety and Depression Scale (HADS) and Quality of Life (QLQ-30) scores were registered at baseline (T0), and after treatment (two cycles [T2] and four cycles [T4]). For each subscale of HADS, scores were rated: <7 as negative, 8-10 as low and 11-21 as severe. Score changes on emotional subscales were analyzed with Wilcoxon test.
Results:
Most patients reported normal levels of anxiety and depression at all times of the evaluation. Anxiety reduced significantly at T2 (p=0.007) and T4 (p=0.001). Depression rates remained stable, but were associated with worse global QoL scores (p=0.001), fatigue (p=0.010), emotional distress (p=0.001) and social distress (p=0.011).
Conclusion:
Anxiety and depression rates are highly prevalent in patients with EGFR mutations. The changes found on subscales scores may be due to several factors such as quality of life, performance status, response to treatment, a heightened perception of control and the expectation of having a better prognosis, among other factors. Since the needs of the patients vary according to treatment type, further studies on the emotional status of patients treated with novel therapeutic agents are warranted in order to understand factors that stimulate emotional well-being.
