Abstract 600P
Background
The promising novel therapies for early-stage NSCLC call for optimized management in the real world. We present treatment (Tx) patterns and associated survival from the MEA cohort of the retrospective THASSOS-INTL study (NCT04808050).
Methods
Patients (pts) with clinical stage (CS) IA-IIIB resectable NSCLC (7th AJCC) diagnosed from 2013 to 2017 and followed for survival/progression until death, last medical record, or Dec 2020 were eligible. Primary endpoints: Tx patterns (surgery [Sx], neoadjuvant therapy [NT], adjuvant therapy [AT], and NT + AT) and 3-yr survival rate.
Results
Of 268 pts enrolled (median [range] age 59 [22–87] yrs; 78.0% [209] male; 70.1% [188] current/former smokers), 76.1% (204) had CS II (36.9% [99]) or CS III (39.2% [105]). Adenocarcinoma (53.4% [143]) was the major histologic type with 63.1% (169) right lung involvement and 52.6% (141) at pN0. Of 48 pts tested for EGFR, 14.6% (7) were positive while 43.8% (7/16 tested) had PD-L1 expression (≥1%: 2; unknown: 5). Overall, 63.4% (170/268) had Sx (lobectomy 74.7% [127]) of whom 19.4% (33/170) had Sx alone; 34.7% (93) received NT, 56.7% (152) received AT, and 4.5% (12) received NT+AT (Table). Of 47.0% (126) with disease progression (local 28.6% [36]; distant 31.0% [39]; CNS metastases 18.3% [23]), 67.5% (85) received systemic therapy (ST) and 48.4% (61) received radiotherapy (RT). Median overall survival (mOS) was 9.0 (8.0-not available [NA]) yrs with a 3-yr survival rate across all stages of 83.0% (78.3%-88.0%). Table: 600P
| Tx | Overall N=268 | CS IA N=26 | CS IB N=35 | CS IIA N=58 | CS IIB N=41 | CS IIIA N=79 | CS IIIB N=26 |
| Tx patterns, n, % | |||||||
| Sx only | 33, 12.3 | 15, 57.7 | 8, 22.2 | 3, 5.2 | 1, 2.4 | 5, 6.3 | 1, 3.8 |
| NT | 93, 34.7 | 3, 11.5 | 6, 16.7 | 14, 24.1 | 19, 46.3 | 36, 45.6 | 14, 53.8 |
| AT | 152, 56.7 | 8, 30.8 | 22, 61.1 | 43, 74.1 | 23, 56.1 | 44, 55.7 | 11, 42.3 |
| NT + AT | 12, 4.5 | 0 | 0 | 2, 3.4 | 2, 4.9 | 8, 10.1 | 0 |
| Tx modalities, n, % | |||||||
| ST | 169, 63.1 | 9, 34.6 | 23, 63.9 | 48, 82.8 | 34, 82.9 | 45, 57.0 | 9, 34.6 |
| RT | 3, 1.1 | 1, 3.8 | 1, 2.8 | 0 | 0 | 1, 1.3 | 0 |
| ST + RT | 73, 27.2 | 1, 3.8 | 4, 11.1 | 9, 15.5 | 8, 19.5 | 34, 43.0 | 16, 63.5 |
| Survival, 95% CI | |||||||
| mOS, yrs | 9.0, 8.0–NA | NA | 8.0, 7.8–NA | NA, 7.7– NA | 8.7, 8.7– NA | 9.0, 5.3– NA | NA, 2.0– NA |
| 3-yr survival, % | 83.0, 78.3–88.0 | 100 | 89.6, 79.1–100 | 87.5, 78.6– 97.5 | 79.3, 67.4– 93.2 | 79.2, 69.8– 89.8 | 62.1, 43.8–88.0 |
Conclusions
Our results showed >50% pts received AT and ∼35% pts received NT, mostly in CS II and CS III with a mOS of 9 yrs. Although the EGFR mutation rate and PD-L1 expression were similar to previous studies, testing rates were low likely due to the lack of anti-EGFR agents in the AT setting. The recent advent of new targeted and immunotherapies calls for multidisciplinary team involvement to improve upfront biomarker work-up at diagnosis and use of novel agents in NT and/or AT settings.
Clinical trial identification
NCT04808050.
Editorial acknowledgement
The authors would also like to thank Dr. Debasri Mukherjee and Dr. Soma Das of Fortrea Scientific Pvt Ltd for medical writing support that was funded by AstraZeneca FZ LLC.
Legal entity responsible for the study
AstraZeneca FZ LLC.
Funding
AstraZeneca FZ LLC.
Disclosure
A. Seyam, M. Mancy, V. Rajadhyaksha: Financial Interests, Institutional, Full or part-time Employment: AstraZeneca. All other authors have declared no conflicts of interest.