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.
Resources from the same session
4679 - Correlative analyses of serum biomarkers and efficacy outcomes in the randomized phase 2 trial of lenvatinib (LEN), everolimus (EVE), or LEN+EVE in patients with metastatic renal cell carcinoma
Presenter: Chung-Han Lee
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
Resources:
Abstract
5379 - End-to-end learning to predict survival in patients with gastric cancer using convolutional neural networks
Presenter: Armin Meier
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
Resources:
Abstract
5394 - Detection of Targetable Kinase Fusions in 7260 patients in an integrated Cancer System
Presenter: Ankur Parikh
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
Resources:
Abstract
5884 - Clinical and analytical validation of an FDA approved comprehensive genomic profiling (CGP) assay incorporating multiple companion diagnostics for targeted and immunotherapies
Presenter: Yali Li
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
Resources:
Abstract
5912 - SET overexpression promotes colorectal cancer progression and determines poor outcome in patients with localized disease.
Presenter: Blanca Torrejón
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
Resources:
Abstract
1168 - The functional MDM4 genetic variant in advanced lung adenocarcinoma patients treated with EGFR-TKIs
Presenter: Nasha Zhang
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
Resources:
Abstract
3071 - PD-L1 expression on pre-treatment circulating tumour cells, but not serum VEGF, is predictive of response to pembrolizumab in melanoma
Presenter: Muhammad Khattak
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
Resources:
Abstract
4062 - Olaparib plus paclitaxel sensitivity in biomarker subgroups of gastric cancer
Presenter: Yu-Zhen Liu
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
Resources:
Abstract
4801 - A diagnostic model for hepatitis B virus-related hepatocellular carcinoma in China: a large-scale, multi-center study
Presenter: Tian Yang
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
Resources:
Abstract
4874 - Dissecting Gastric Cancer biology and how and when to use immunotherapy
Presenter: Meghna Das Thakur
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
Resources:
Abstract