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J. Marghadi
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-038 - Determinants of Frailty and Treatment Toxicity in Non-Small Cell Lung Cancer Patient (ID 9566)
09:00 - 09:00 | Author(s): J. Marghadi
- Abstract
Background:
Platinum-based chemotherapy remains a first line treatment for advanced non-small-cell lung cancers (NSCLC). Despite better individualization of treatment, some patients will seek frequent medical attention because of cancer-related complications or treatment toxicity. This can negatively impact patient’s quality of life and health care resources. This study aimed to identify biological and clinical factors predictive of frailty and treatment toxicity among NSCLC patients eligible for first-line platinum-based chemotherapy.
Method:
Using our institutional medical charts, we retrospectively extracted data on stage III and IV NSCLC patients diagnosed between December 2011 and November 2015 who had received a first-line platinum based chemotherapy. The primary outcome is defined as any unplanned emergency visit and/or unplanned hospitalization for cancer or treatment related complications. Using multivariate logistic regression model with step by step method, we defined baseline biological and clinical determinants associated with the primary outcome.
Result:Table 1. First Multivariate Analysis
We included 227 patients. Mean age was 60 years old, 65% were male, 46% current smokers, 10% PS 2-3 and 74% had adenocarcinoma histology. 20,7% patients had locally advanced disease (Stage III) treated by chemoradiation and 78,4% had metastatic disease treated by exclusive chemotherapy. Median overall survival (OS) was 15 months and PFS 6 months. Overall, 55 % (122/227) met the primary outcome. There were 14 variables (Table 1) included in the first multivariate analysis before computer based step by step approach. In the final model (not shown), albumin level <35 g/L (OR 2.24 95% IC 1.14- 4.38, p= 0.02) was an independent predictor of the primary outcome. There was also a trend for squamous cell carcinoma subtype (OR 2.27 95% IC 0.872- 5.914, p= 0.09).Variable OR 95% CI Age ≥ 62 Years-old 1.61 0.70 - 3.68 Adenocarcinoma - Squamous Cell Carcinoma - NSCLC other 1 2.43 0.50 0.61- 9.61 1.45 – 1.74 Performance scale ≥ 1 1.35 0.57 – 3.18 Number of metastasis ≥ 2 1.36 0.58 – 3.18 Pleural metastasis 2.04 0.53 – 7.86 Weight loss ≥10% or ≥3 kg 1.00 0.41 – 2.43 ≥ 3 prescription drugs per day 0.98 0.42 – 2.28 Current smoker - Former Smoker - Never smoker 1 0.56 1.10 0.24 – 1.30 0.24 – 5.11 Neutrophils count ≥ 7500/ mm[3] 1.57 0.70 – 3.54 Lymphocytes count ≤ 1000/ mm[3] 1.04 0.34 – 3.22 Albumin ≤ 35 g/L 2.70 0.93 – 7.69 LDH ≥ 247 U/L 0.93 0.37 – 2.30
Conclusion:
Low albumin level is a determinant of frailty in patients eligible for platinum-based chemotherapy. Early intervention in these subgroups could benefit patient’s quality of life and health care expenses. (Medicoeconomic analysis will be presented).
