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Poster display session

516P - Clinical outcomes in elderly patients with advanced non-small cell lung cancer: A prospective multicenter study of the National Hospital Organization in Japan

Date

23 Nov 2019

Session

Poster display session

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Masahiro Shimada

Citation

Annals of Oncology (2019) 30 (suppl_9): ix157-ix181. 10.1093/annonc/mdz437

Authors

M. Shimada1, M. Kanazu2, M. Shimokawa3, R. Saito4, M. Mori2, A. Tamura1, Y. Okano5, Y. Fujita6, T. Endo7, M. Motegi8, S. Takata9, T. Kita10, N. Sukoh11, M. Takenoyama12, S. Atagi13

Author affiliations

  • 1 Respiratory Medicine, National Hospital Organization, Tokyo National Hospital, 204-8585 - Kiyose/JP
  • 2 Department Of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, 560-0045 - Toyonaka/JP
  • 3 Clinical Research Institute, National Hospital Organization Kyusyu Cancer Center, 811-1395 - Fukuoka/JP
  • 4 Division Of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, 377-0280 - Shibukawa/JP
  • 5 Division Of Respiratory Medicine, National Hospital Organization, Kochi National Hospital, 780-8077 - Kochi/JP
  • 6 Department Of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, 070-8644 - Asahikawa/JP
  • 7 Department Of Respiratory Medicine, National Hospital Organization Mito Medical Center, 311-3193 - Mito/JP
  • 8 Department Of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, 370-0829 - Takasaki/JP
  • 9 Department Of Respiratory Medicine, National Hospital Organization Fukuoka-Higashi Medical Center, 811-3195 - Koga/JP
  • 10 Department Of Respiratory Medicine, National Hospital Organization Kanazawa Medical Center, 920-8650 - Kanazawa/JP
  • 11 Department Of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, 063-0005 - Sapporo/JP
  • 12 Department Of Thoracic Oncology, National Hospital Organization Kyusyu Cancer Center, 811-1395 - Fukuoka/JP
  • 13 Department Of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, 591-8555 - Sakai/JP

Resources

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Abstract 516P

Background

Previous studies have developed risk stratification schemas to assess chemotherapy toxicity. However, the geriatric assessment variables that should be used to assess the individual risk of severe chemotherapy toxicity and clinical outcomes in elderly patients remain controversial.

Methods

Patients aged ≥70 years with advanced non-small cell lung cancer (NSCLC) who were treated at 24 National Hospital Organization institutions and completed a pre- first-line chemotherapy assessment were included in this study. The assessment included the following: patient characteristics, treatment variables (platinum doublet: PD, single agent: SA, tyrosine kinase inhibitor: TKI), laboratory test values, and geriatric assessment variables. We analyzed the correlations between each factor and clinical outcomes of chemotherapy and overall survival (OS).

Results

In total, 348 patients with advanced NSCLC, with a median age of 76 years (range, 70 to 95 years), joined this prospective study. In all patients, the best objective response rate and disease control rate were 35.6% and 81.0%, respectively. The median progression-free survival (PFS) and OS were 6.1 and 16.5 months, respectively. Performance status, treatment variables, and several laboratory test results (anemia, albumin, and C-reactive protein) affected the best response of chemotherapy (p = 0.0249, <0.001, <0.001, <0.001, and <0.001 respectively, between disease control and progressive disease cohorts). These factors also affected the PFS of first-line therapy (5.8 (PD) vs 3.5 (SA) vs 10.5 (TKI), and 2.9 vs 6.4, 2.9 vs 6.3, 3.0 vs 6.5, 3.0 vs 7.0 months respectively, between above or below each cutoff cohort) and OS (13.7 (PD) vs 10.4 (SA) vs 30.6 (TKI), and 7.0 vs 16.8, 6.3 vs 16.8, 6.6 vs 17.8, 6.2 vs 18.1 months, between above or below each cutoff cohort).

Conclusions

Performance status, treatment variables, and several laboratory test values independently predicted clinical outcomes of chemotherapy in elderly patients with advanced NSCLC.

Clinical trial identification

UMIN000010384.

Editorial acknowledgement

Legal entity responsible for the study

National Hospital Organization.

Funding

National Hospital Organization.

Disclosure

All authors have declared no conflicts of interest.

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