Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

H. Cordero



Author of

  • +

    P2.01 - Advanced NSCLC (ID 618)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
    • +

      P2.01-050 - Predicting Risk of Hospitalization in Patients with NSCLC Receiving Chemotherapy Using the LCSS 3-Item Global Index (3-IGI) (ID 10313)

      09:00 - 09:00  |  Author(s): H. Cordero

      • Abstract

      Background:
      A leading factor of poor treatment outcomes and cost in cancer care is hospitalization. If hospitalization risk can be accurately predicted, preventive interventions can be effectively used and treatment regimen selection may be able to be refined. Currently, oncologists do not routinely use laboratory, molecular, PRO or imaging data to predict risk of hospitalization or its prevention. Prior research demonstrated that the 3-IGI (quality of life, activities, distress) of the LCSS at baseline, predicts survival more accurately than performance status and requires only two minutes for administration.

      Method:
      The objective was to determine if the 3-IGI measured at baseline accurately predicts cancer-related or treatment toxicity-related hospitalization risk. PROs were prospectively evaluated in 164 patients receiving chemotherapy for advanced NSCLC using the LCSS 3-IGI, with electronic assistance (“eLCSS-QL”). Patients were followed for hospitalization over three months. Hospitalizations were characterized as cancer-related, or treatment toxicity-related.

      Result:
      Characteristics: 57% men; 92% Stage IV; 73% first-line therapy; mean age 63; ECOG 1/2: 56%/42%. 77 hospitalizations occurred among 53 (33%) patients. Patients were placed into 3-IGI groups based on scores at baseline by thirds (tertiles; mean 3-IGI = 188 with 0=worst, 300=best; 33[rd] percentile <162, and 67[th] percentile > 239). Baseline 3-IGI significantly predicted risk of cancer-related hospitalizations (p<0.0001), but not treatment toxicity-related hospitalizations (27%, p=0.69). The table outlines marked differences in hospitalizations associated with baseline 3-IGI groups.

      PERCENT OF HOSPITALIZATIONS BY 3-IGI GROUP AT BASELINE (p = 0.0001)
      TIME FROM BASELINE: LEAST-RISK GROUP MEDIUM-RISK GROUP HIGHEST-RISK GROUP
      30-DAYS 0% 18% 23%
      60-DAYS 10% 20% 39%
      90-DAYS 12% 27% (HR 2.7) 41% (HR 4.6)
      Additionally, in only those in the ECOG=1 group, the 3-IGI significantly identified cancer-related hospitalization risk (p=0.025).

      Conclusion:
      The 3-IGI of the LCSS significantly identifies risk of hospitalization in patients receiving chemotherapy for NSCLC, and is more accurate than ECOG PS. Interventions (including enhanced monitoring) focused on identifiable high risk groups is warranted to reduce hospitalization. These results may also help in appropriate regimen choice to reduce hospitalization. Such interventions could improve cancer care and reduce costs. Support: NIH/NCI R01 CA-157409