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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

4292 - The standard of care for stage III NSCLC in the era of Immunotherapy: an Italian National Survey on the current pattern of care among Italian Thoracic Oncologists

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Immunotherapy

Tumour Site

Presenters

Alessio Bruni

Citation

Annals of Oncology (2018) 29 (suppl_8): viii488-viii492. 10.1093/annonc/mdy291

Authors

A. Bruni1, F. Grossi2, F. Katia3, E. Capelletto4, L. Buffoni4, S. Badellino5, V. Poletti6, R. Chiari7, N. Giaj Levra8, G.L. Banna9, S. Vagge10, P. Borghetti11, E. Baldini12, E. Bria13, M. Tiseo14, M. Paci15, P. Ciammella16, M. Taraborrelli17, U. Ricardi18, V. Scotti19

Author affiliations

  • 1 Oncology And Hematology - Radiotherapy Unit, Azienda Ospedaliero - Universitaria Policlinico di Modena, 41125 - Modena/IT
  • 2 Department Of Oncology, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 - Genova/IT
  • 3 Thoracic And Lung Physiopathology, Unit, ”Careggi“ University Hospital, 50100 - Florence/IT
  • 4 Department Of Oncology, Azienda Ospedaliera Universitaria San Luigi Gonzaga, 10043 - Orbassano/IT
  • 5 Department Of Oncology, University of Turin, AOU Città della Salute e della Scienza, Turin/IT
  • 6 Department Thoracic Diseases, Pulmonary Operative Unit, “Morgagni-Pierantoni” Hospital, Forlì,/IT
  • 7 Medical Oncology Unit, Azienda Ospedaliera di Perugia S. Maria della Misericordia, 6132 - Perugia/IT
  • 8 Radiation oncology Unit,, “Sacro Cuore Don Calabria” Hospital, Verona/IT
  • 9 Medical Oncology, Cannizzaro Hospital, Catania/IT
  • 10 Radiation oncology Department, IRCCS Policlinico San Martino, 16132 - Genova/IT
  • 11 Radiation oncology Department, “Spedali Civili” University Hospital, Brescia/IT
  • 12 Department Of Oncology, Division Of Oncologyy, S. Luca Hospital,, Lucca/IT
  • 13 Uoc Oncologia Medica, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario Agostino Gemelli, 00168 - Rome/IT
  • 14 Medical Oncology, AOU di Parma, 43126 - Parma/IT
  • 15 Thoracic Surgery Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia/IT
  • 16 Radiation oncology Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia,/IT
  • 17 Department Of Radiation oncology, SS. Annunziata Hospital, G. D'Annunzio, Chieti/IT
  • 18 Department Of Oncology, Radiotherapy Unit, University of Turin, AOU Città della Salute e della Scienza, 10126 - Torino/IT
  • 19 Radiation oncology Unit, Oncology Department, Careggi University Hospital, 50134 - Florence/IT
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Resources

Abstract 4292

Background

Concurrent Chemo-Radiotherapy (cCRT) is standard treatment in “fit patients” (pts) affected with locally advanced (LA) NSCLC, with surgery limited to few selected cases. Despite some improvements, outcomes are still unsatisfactory, with only 15-25% of pts alive at 5 years. Recently, encouraging results were obtained with the addition of immunotherapy (IT) to cCRT. Survey was conducted to evaluate the pattern of care of LA-NSCLC treatment among Italian Thoracic Oncologists (TO) involving pneumologists, thoracic surgeons, radiation and medical oncologists.

Methods

In February 2018, all Italian TO were invited to participate to a “web-based” survey consisting in 15 multiple-choice questions about staging procedures and most appropriate multimodal approach to manage LA-NSCLC. Questions were also focused on diagnostic imaging and histopathological modalities.

Results

421 responses were analyzed;69% of responders had more than 5 years experience in thoracic oncology. In 72% of Centers, TO regularly attend a weekly multidisciplinary Team (MDT) meeting, while in 28% MDT is not regularly planned. About pathology, cytological/histological morphologic diagnosis of malignancy were considered enough to define a therapeutic approach in 63% of responders. In N2, Stage IIIA, "minimal" pts upfront surgery was considered the preferred option from 43% of responders, while in N2, multi-nodal and/or bulky pts cCRT was recommended. For this latter group (“unresectable”) only 54% considered cCRT the most appropriate choice, while 46% preferred a sequential chemo-RT, even in fit pts due to better pts compliance and lower toxicity profiles.

Conclusions

Our analysis showed an inhomogeneous scenario between different specialists regarding the appropriate therapeutic choices for LA-NSCLC treatment. Additionally, some discrepancies were found about a correct selection of pts fit for cCRT. Many efforts have to be put towards the increase of a true multidisciplinarity, since in many Institutions lack of MDT was described. Future investigations and trials are necessary to optimize treatment approaches in LA-NSCLC, in particular considering recent clinical results on combination of cCRT and IT.

Clinical trial identification

Legal entity responsible for the study

Alessio Bruni.

Funding

AstraZeneca.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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