306P - Multimodal management and outcomes of stage III non-small cell lung cancer: KINDLE-Egypt analysis

Background

With a diverse disease presentation and complex therapeutic strategies, optimal management of stage III NSCLC is a challenge in Egypt. We present treatment patterns and survival outcomes in pre-immuno-oncology era from Egypt cohort of the real-world multi-country KINDLE study.

Methods

We analyzed retrospective data from Egypt subset (21 centers) of adults diagnosed with locally-advanced stage III NSCLC (AJCC 7th edition) between January 2013 and December 2017, with at least 9 months of documented follow-up. Descriptive and inferential statistics analyzed treatment, progression-free survival (PFS) and overall survival (OS).

Results

Overall, 421 patients (resectable n = 69, unresectable n = 250) were enrolled (Table). As initial line of treatment, most resectable patients underwent chemotherapy + surgery (33.8%), surgery (other surgery [20.6%] or surgery alone [20.6%]), while chemotherapy (CT) was preferred (48.8%) in unresectable patients. Overall median PFS was 10.3 months (m) (95% CI 9.43 to 12.02), while median OS was 18.5 m (95% CI 16.46 to 21.88). Median PFS was 20.8 m for surgery+CT versus sequential chemoradiotherapy (sCRT) 18.5 m (p = 0.615) in resectable, and 10.5 m for cCRT versus sCRT 7.1 m (p = 0.024) in unresectable patients. Median OS was 27.8 m for CT (NC for other treatments) in resectable patients. Improved OS was observed in unresectable patients for cCRT (18.3 m) versus CT (14.3 m; p = 0.0415), cCRT (18.3 m) versus radiotherapy (RT) (10.9 m; p = 0.005), sCRT (21.3 m) versus RT (10.9 m; p = 0.029) and RT (10.9 m) versus targeted therapy (16.0 m; p = 0.016). Overall, female gender and surgery as initial therapy were associated with improved PFS, and adenocarcinoma was associated with improved OS. Table: 306P

AJCC: American Joint Committee on Cancer; cCRT: concurrent chemoradiotherapy; Chemotherapy: CT; RT: radiotherapy; sCRT: sequential chemoradiotherapy *Other Surgery includes any kind of therapy used in combination with surgery (except for the following: surgery alone, surgery + sCRT, surgery + CT) each pattern has less than 10 patients

Conclusions

KINDLE-Egypt cohort reveals diverse treatment in stage III NSCLC. Although deemed resectable, around 10% patients did not undergo surgery, potentially due to high smoking rates and poor lung function. Our survival outcomes are lower than other published real-world studies. Timely approval and availability of novel targeted and immunotherapies can enhance patient outcomes.

Clinical trial identification

Editorial acknowledgement

The authors thank Piyalee Pal from Labcorp Scientific Services & Solutions Private Limited for providing medical writing support of the abstract. The authors also acknowledge Dr. Rabab Gaafar - National Cancer Institute, Cairo, Egypt for her contribution in the study.

Legal entity responsible for the study

AstraZeneca.

Funding

AstraZeneca.

Disclosure

All authors have declared no conflicts of interest.