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K. Chomprasert



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    P2.01 - Advanced NSCLC (ID 618)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.01-002 - Survival of Patients with Advanced Non-Small Cell Lung Cancer at Single Institute in Eastern Thailand, 2013-2016 (ID 7502)

      09:00 - 09:00  |  Author(s): K. Chomprasert

      • Abstract
      • Slides

      Background:
      In 2012, lung cancer was the leading cause of death from malignancy in Thailand. The management of advanced non-smll cell lung carcinoma (NSCLC) was rapidly developed in the last decade. The patients were tailored treated according to their histology and molecular profiles, which contributed to significant improvement of survival, especially in the molecular-selected patient.

      Method:
      This retrospective study was conducted by reviewing medical records of stage IIIB-IV NSCLC patients treated at Chonburi Cancer Hospital, from July 2013 to June 2016. To study the survival of the patient, also focus on an epidermal growth factor receptor (EGFR) mutation testing including an epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy in clinical practice and to find a prognostic factor for the survival.

      Result:
      This study enrolled 148 patients with median follow up time 7.90 months. Median age was 60.5 (range 25-91). There were male 64%, non-smokers 37%, stage IIIB/IV 17/83% and adenocarcinoma/squamous cell carcinoma 74/13 %. The Eastern cooperative oncology group (ECOG) 0-1, 2-4 and no record were found 35%, 36% and 29 %, respectively. The median survival time of all patients was 8.04 months. Median survival times of patients receiving and not receiving systemic therapy were 10.60 months and 3.00 months, respectively (p <0.001). However, a median survival of the EGFR mutation patient was not reach. One hundred twenty one patients (121/148, 81.7%; chemotherapy118, EGFR-TKI 3) received first-line systemic therapy.Fifty patients (50/148, 33.8%) and fifteen patients (15/148, 10.1%) received second- and third-line systemic therapies, respectively. The most common first-and second-line systemic therapies were platinum doublet (116/121) and docetaxel (32/50), respectively. Eighteen percent (27/148) of the patients were tested for EGFR mutations. Fifty five percent (15/27) of the patients tested for EGFR status were sensitive mutations. Unfortunately, only some of sensitive EGFR mutation patients could really access to an EGFR-TKI therapy and mostly received it as a late-line of treatment. Multivariate analysis showed that ECOG performance status 2-4 (p<0.001), no record for ECOG (p=0.001), no lung metastasis (p=0.012) and unknown EGFR (p=0.001) indicated significantly unfavorable prognostic factors for the survival.

      Conclusion:
      The survival time of advanced NSCLC in our institute was comparable to pivotal studies. Obviously, in real-life clinical practice in Thailand, EGFR mutation testing was quite low because of financial limitation to get access to a targeted therapy. The poor ECOG performance status, no record for ECOG performance status, no lung metastasis and unknown EGFR mutation were poor prognostic factors for the overall survival.

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