183P - Second-line treatment selection in patients with non-small cell lung cancer of adenocarcinoma histology: A European survey

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Anticancer agents
Non-Small Cell Lung Cancer
Biological Therapy
Presenter Nicolas Girard
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors N. Girard1, J. Corral2, D. Cortinovis3, D. Heigener4
  • 1Louis Pradel Hospital, Claude Bernard University, 69500 - Lyon/FR
  • 2Medical Oncology, Hospital Universitario Virgen del Rocio, 41013 - Sevilla/ES
  • 3Unità Operativa Oncologia Medica, Azienda Ospedaliera S. Gerardo U.O. Oncologia Medica, 20052 - Monza/IT
  • 4Center For Pneumology And Thoracic Surgery, Hospital Grosshansdorf, 22927 - Grosshansdorf/DE



Guidelines provide treatment recommendations for patients with advanced non-small cell lung cancer (NSCLC), yet physicians must also consider factors such as patient characteristics/medication access. We surveyed physicians who treat patients with NSCLC to determine their therapy goals, drivers of treatment choice, current prescribing behaviour and therapy expectations.


We conducted an online survey of 500 pulmonologists/oncologists treating patients with NSCLC in Germany, France, Italy, Spain and the UK between March-April 2015. Physicians were asked 20 questions about therapy decisions in patients with stage IIIb/IV NSCLC with adenocarcinoma histology and no actionable biomarkers.


Therapy goals were dependent on Eastern Cooperative Oncology Group performance status (ECOG): in patients with ECOG 0–1, physicians most commonly chose 2nd-line treatment based on overall survival (OS; 40%), followed by ability to stabilise disease (19%) and improved quality of life (QoL; 14%); in patients with ECOG ≥2, improvement in QoL (26%), tumour-related symptoms (23%) and OS (17%) were the most common goals. Goals were similar between countries. Most physicians (57%) favoured 2nd-line treatments that extend OS while maintaining QoL, although 45% agreed that QoL and stable disease are more important than extended life. Product features considered to be the most important for 2nd-line treatment were generally similar to the therapy goals of increasing OS and maintaining QoL. Common identified unmet needs were ‘stopping tumour progression for a long time’ (66%), ‘extending survival without compromising QoL’ (61%) and ‘overall cost–benefit ratio’ (54%).


Physician attitudes to treatments were generally aligned across countries surveyed. OS is an important feature for 2nd-line treatments in patients with stage IIIb/IV unselected NSCLC of adenocarcinoma although the benefit to QoL should not be overlooked when evaluating new treatments. Despite emerging data on new treatment options, the unmet needs identified within this survey, indicate that access to therapy is a key factor in whether patients benefit from these therapies in the real world.

Clinical trial identification


Legal entity responsible for the study

Boehringer Ingelheim GmbH, Kantar Health GmbH


Boehringer Ingelheim GmbH


N. Girard: Consultant for Boehringer Ingelheim and BMS outside the submitted work; and has received Medical writing assistance from inVentiv Medical Communications. J. Corral, D. Cortinovis: Medical writing assistance from inVentiv Medical Communications. D. Heigener: Personal fees from Boehringer Ingelheim, Eli Lilly, Bristol Myers Squibb, Hoffman laRoche, Pfizer. Medical writing assistance from inVentiv Medical Communications.