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N. Teich



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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
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      P1.06-024 - Outcome of Non-Small Cell Lung Cancer Patients Treated in the Private Health Care in Brazil (ID 9010)

      09:30 - 09:30  |  Author(s): N. Teich

      • Abstract
      • Slides

      Background:
      Developing countries often present a dichotomous health care system, where patients may be treated in either public or private institutions that differ substantially in terms of level of access to diagnostic and therapeutics procedures. Herein, we present the first report of this comprehensive study to assess real-world data in non-small cell lung cancer (NSCLC) patients treated in the private health care in Brazil.

      Method:
      This is a prospective study of lung cancer patients treated in a private health care institution, comprising six unities in Rio de Janeiro and surroundings. Eligible patients were at least 18 years old and had a histology-proven diagnosis of lung cancer between July 2012 and February 2017. For this analysis, only NSCLC patients with an invasive component were included. Patients or relatives were contacted by telephone to ensure that all information was annotated. Data quality was certified by regular monitoring. This study was approved by the local Research Ethics Committee.

      Result:
      Six hundred twenty-eight patients were enrolled. Eighty-three were excluded in this analysis due to small-cell (57), carcinoid (5), in situ carcinoma (5), and other histological subtypes (16). The final report comprises 545 NSCLC patients, predominantly of non-squamous histology (76.5%). Median age was 68 years (range 21-93), and most cases were males (54.3%). Most patients were current (28.3%) or former (49.7%) smokers, diagnosed in advanced stages (stage III in 20.7% and stage IV in 57.2%). Treatment had a curative intent in 38.9% of times, and included surgery in 29.4%. Palliative chemotherapy was delivered in 64.5% of times, while adjuvant and neoadjuvant chemotherapy was used in 10.2% and 5.4%, respectively. Radiotherapy was used in 53.9% of cases. Molecular testing was available for 49.3% of cases, mostly in non-squamous histology (92.8%) and in advanced stages (stages III/IV in 74.8%). Median overall survival was 25.3 months (95% CI 22.0-28.6). Factors significantly correlated to OS were disease stage, performance status, tumor grade, gender, and weight loss (p<0.01 in all). Among patients with metastatic or recurrent disease, OS was significantly longer in those with a molecular testing (p<0.01).

      Conclusion:
      To our knowledge, this is the most comprehensive and best-annotated study in this scenario. Outcomes were favorably similar to the current literature from developed countries in all stages, which suggest that data generated from international clinical trials should be reproducible locally. Our dataset may serve as a foundation to guide resource allocation in the years to come.

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