126P - Outcomes over a decade in stage IV non-small cell lung cancer (NSCLC): The Clatterbridge Cancer Centre experience

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Non-Small-Cell Lung Cancer, Metastatic
Presenter Carles Escriu
Citation Annals of Oncology (2015) 26 (suppl_1): 29-44. 10.1093/annonc/mdv050
Authors C. Escriu1, H. Wong2, E. Marshall1
  • 1Medical Oncology, Clatterbridge Cancer Centre, CH63 4JY - Liverpool/UK
  • 2Clinical Effectivenes Team & Statistics, Clatterbridge Cancer Centre, CH63 4JY - Liverpool/UK

Abstract

Aim/Background

NSCLC drug treatment has undergone substantial changes over recent years. We aimed to assess the changes implemented in our Cancer Centre and investigate their impact on overall survival in our stable real-life population.

Methods

We focused on patients treated for stage IV disease, a homogeneous population managed with systemic drug therapy. Two groups of patients treated in a two-year period each, within a ten-year range, were identified in our prospective database. We discerned therapeutic changes, quantified toxicity indicators, and used Log-rank test to compare overall survival.

Results

Between 2002 and 2004, 1,804 lung cancer patients were referred, 763 with stage IV, of which 154 (20%) with recorded WHO Performance Status (PS) 0-1. 253 (33%) had systemic treatment. Between 2010 and 2012, 2,008 lung cancer patients were referred, 935 with stage IV, 286 (30%) with PS0-1. 325 (34%) patients had systemic treatment. In this 2010-12 group, half of the treated patients (174/325) had adenocarcinoma. 48 received first line platinum and Pemetrexed combination (46 with Cisplatin), and 26 had maintenance Pemetrexed. 76 patients had second line treatment and 19, third line. The proportional use of EGFR inhibitors increased in successive treatment lines. Early Discontinuation Rates (EDR) of EGFR inhibitors was particularly high in the second line (54%). Bevacizumab was not licensed by NICE and Crizotinib use started after 2012, therefore their effects could not be accounted for here. Comparing the treated patients in the 2002-04 and 2010-12 groups, there were no differences in 30-day mortality (17 versus 16.9%). The one-year survival rate of treated stage IV NSCLC patients was 34% in the first group and 32% in the second. No significant differences in overall survival were found regardless of histological subtype and PS.

Conclusions

Our results indicate that most of our patients presented with advanced cancer, and suggest that the changes implemented within a decade did not influence group survival of treated stage IV NSCLC patients. This supports the need to optimize novel therapy implementation in real practice, and promote early diagnosis, novel pathway inhibition and predictive biomarker research.

Disclosure

All authors have declared no conflicts of interest.