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D. Layton
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P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.06-012 - Non-Small Cell Lung Cancer (NSCLC) Patient Characteristics and Clinical Care Insights in Sweden: The SCAN-LEAF Study (ID 9537)
09:30 - 09:30 | Author(s): D. Layton
- Abstract
Background:
Understanding non-small cell lung cancer (NSCLC) epidemiology and outcomes is fundamental for clinical decision-making. SCAN-LEAF is a retrospective longitudinal cohort study that aims to describe NSCLC epidemiology, clinical care, and outcomes of patients in Scandinavia. The present analyses examine clinical characteristics and disease management of a subset of these patients.
Method:
Cohort 2 (EMR data from Uppsala, Stockholm sites, extracted using the Pygargus Customized Extraction Platform (CXP 3.0) and linked to registry data) consisted of NSCLC patients diagnosed 2005-2013 (follow-up until 2014). Co-morbidity burden was calculated with the Charlson Co-morbidity Index (CCI). Descriptive statistics were calculated, stratified by disease stage at diagnosis [resectable: I-IIIA; locally advanced: IIIA-B (radiation therapy within 3 months); advanced: IIIB (no radiation therapy within 3 months)-IV].
Result:
48.4% of the 3984 patients were male. At diagnosis, mean age was 68.4 years with disease stage distribution: resectable (30.4%), locally advanced (10.5%), advanced (56.3%), not specified (2.7%). CCI distribution was similar between stages, as was BMI. Smoking status: never (7.4%), former smoker (34.7%), current smoker (25.6%), unknown (32.4%). Histology: adenocarcinoma (63.3%), squamous (20.5%), NSCLC NOS (Not Otherwise Specified) (16.2%). ECOG: 0/1 (48.4%), 2/3 (13.2%), 4 (2.2%), unknown (36.2%). Metastases at diagnosis were reported for 42.4% patients. 829 patients were tested for molecular sub-type EGFR (of which 751 had a valid test result, of which 14.6% were positive for the mutation) and 267 for ALK (of which 247 had a valid test result, of which 14.6% were positive for the rearrangement). More patients with locally advanced disease were treated with radiation than patients with resectable or advanced disease [(68.8%, n=289) vs (35.9%, n=436) and (47.4%, n=1064), respectively], and a greater proportion of locally advanced patients received systemic therapy [(72.1%, n=303) vs (39.4%, n=478) and (67.1%, n=1505), respectively]. The proportion of patients not treated with surgery, radiation, or systemic therapy (based on pre-selected procedure lists) was higher for advanced (22.3%, n=500) vs resectable (6.5%, n=79) and locally advanced disease (11.9%, n=50).
Conclusion:
SCAN-LEAF EMR data provides unique insights into Scandinavian NSCLC patient populations and treatments. These data suggest unmet medical need based on majority of patients being diagnosed at advanced stage and low numbers tested for molecular subtype mutation but we expect these dynamics to change over time. Additionally, our data suggest unmet treatment need in patients with advanced disease based on a high proportion receiving no surgery, radiation, or systemic therapy, whilst acknowledging potential for misclassification and/or missing treatment data.
