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Cheng Chieh Hsu
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P1.11 - Patient Advocacy (ID 697)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Patient Advocacy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.11-002 - Lung Cancer in Nonagenarian Patients (ID 7981)
09:30 - 09:30 | Presenting Author(s): Cheng Chieh Hsu
- Abstract
Background:
More than half lung cancer patients were aged more than 65-year-old. However the information in elderly patients is few, especially in nonagenarian (more than 90 year old).
Method:
We retrospectively collected clinical data of the lung cancer patient aged more than 90 year old between 2010 and 2014 in single medical center in Taiwan. The characteristics, treatment modality, and survival time were analyzed.
Result:
Eighty-three patients were enrolled: 76 patients (91.6%) were non-small cell carcinoma (NSCLC), and 7 patients (8.4%) were small cell carcinoma (SCLC), with the median overall survival (OS) of 30 and 13 weeks, p=0.005. Nine patients were stage I (10.8%), 4 patients were stage II (4.8%), 11 patients were stage III (13.3%), and 59 patients were stage IV (71.7%), with the median OS of 142, 79, 33, and 21 weeks for stage I, II, III, and IV, p<0.001. Better performance status (PS) had longer OS (median OS of 79, 66, 24, 12, and 3 weeks in PS of 0, 1, 2, 3, 4, p<0.001). Patients of simplified comorbidity score (SCS) >9 had shorter OS, but no statistical significance (median OS of 12 and 32 weeks in >9 and ≤ 9 group, p=0.065). For first-line treatment, 61.5% (8 in 13 stage I and II patients) received curative radiotherapy. For stage III patients, 63.6% (7 in 11 patients) received either radiotherapy or chemotherapy alone without concurrent chemo-radiotherapy; in stage IV, 59.3% (35 in 59 patients) received either chemotherapy or targeted therapy. Tumor EGFR mutation status in 30 of 46 stage IV non-squamous NSCLC patients: 55.6% was wild type and L858R was the most frequent. The response patterns in the E19D/L858R/G719X EGFR mutation under EGFR-TKI were 4 partial response, 5 stable disease, 1 progressive disease, and 3 patients were unevaluable (the response rate of 33.3% and the control rate of 75%). In 19 stage IV non-squamous NSCLC patients under EGFR-TKI, the EGFR mutated patients had longer OS than the wild type or unknown status (median OS of 36, 3, 22 weeks in EGFR mutated, wild type, and unknown status, p=0.018).
Conclusion:
Histology, staging, and ECOG PS had statistical significance affecting OS of nonagenarian patients. The lower SCS score patients had insignificant longer OS. The stage IV EGFR mutated non-squamous NSCLC patients under EGFR-TKI had longer OS than wild type or unknown status. Majority of nonagenarian patients could receive first line treatment, and it is important to find out the appropriate treatment for the “fit” patient.
