352P - Impact of novel agent therapy on survival of patients with advanced non-small cell lung cancer in Lebanon

Background

In Lebanon, lung cancer (LC) ranks second in incidence (12.1%) and first in mortality (19.3%).Recent advances in molecular biology has improve survival of patients with lung cancer worldwide. Georgraphic variation in the molecular and biologic characteristics of LC will result in different outcomes of novel agent therapy across different regions. EGFR is found in 15-20% in the Western population, 50% in the Asians and 15.6% in the Lebanese population. ALK rearrangement is found in almost 5% of the Western patients and only 1.9% in the Lebanese population.The PDL-1 expression ranges from 24 to 60% in NSCLC worldwide and 61.7% in Lebanon. knowledge about the impact of novel agent treatment on the survival outcomes in real-world remains unknown in our country.

Methods

This is a retrospective study comparing 130 patients diagnosed with advanced NSCLC that were divided into two groups, group A including patients diagnosed between 2008-2014 and group B between 2015-2019.The primary end-points were to compare the pattern of median overall survival between the two groups and the median overall survival according to the histologic subtype.

Results

Patients in groups A and B had a median age of 68.5 and 67.5 years respectively p=0.842, with a male predominance accounting for two third of the patients in both groups p=0.497. Stage IV was more prevalent than stage IIIB p = 0,420. The non-squamous subtype nearly accounts for two third of the patients in both groups p=0.52. The cumulative median survival was 7.05 months in group A and 15.8 months in group B p<0.0001, (HR =0.39 and CI 0.2268-0,6796). When stratifying by subtype, the median survival of squamous NSCLC increased from 6.96 months in group A to 15.5 months in group B, and from 6.79 in group A to 15.84 months in group B for the non-squamous NSCLC p=0.0012.

Conclusions

This retrospective study describes the pattern of survival of advanced NSCLC between two different eras, the first being before the year 2015 where only chemotherapeutic agents were used in Lebanon, and the second after the year 2015 with the introduction of molecular biology along with the usage of novel agents.The implementation of precision medicine resulted in a significant improvement of the median survival of patients with advanced LC in Lebanon.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.