Abstract 603P
Background
Evolving novel therapies for early-stage NSCLC calls for understanding real-world management practices. We present the treatments (Tx) and associated survival in patients (pts) with clinical stage (CS) I-III NSCLC from the Hong Kong cohort of the retrospective, multi-country, THASSOS-INTL study (NCT04808050).
Methods
Eligible pts diagnosed with CS IA-IIIB resectable NSCLC (7th AJCC) from 2013 to 2017 were followed for survival or disease progression until death, the last medical record entry, or 31/12/2020 (data cut-off). Endpoints were Tx patterns (surgery [Sx], neoadjuvant therapy [NT], adjuvant therapy [AT], and NT + AT) and 3-yr survival rate.
Results
Overall, 89 pts were enrolled (CS I: 32, CS II: 32, CS III: 25; median [range] age 65 [19–83] yrs, male 66.3% [59/89], non-smokers 52.3% [46/88]). Adenocarcinoma was predominant in 73.6% (64/87) with right lung involvement in 57.3% (51/89) and N0 status in 56.2% (50/89). In pts tested for EGFR mutations, 68.4% (26/38) were positive. All pts underwent Sx (lobectomy, 84.3% [75/89]); 48.3% (43/89) had Sx only (CS I 84.4% [27/32], CS II 37.5% [12/32], CS III 16.0% [4/25]). Overall, 51.7% (46/89) received AT; 5 received NT + AT. Majority with CS II (62.5% [20/32]) and CS III (84.0% [21/25]) received AT of whom, most received systemic therapy (ST) in CS II (50.0% [16/32]) while 64.0% (16/25) received both ST and radiotherapy (RT) in CS III. Median (m) OS was 5.9 (95% CI: 4.7–7.0) yrs and reduced from 7.6 yrs in CS IA to 3.7 yrs in CS IIIB. Of 75.3% (67/89) pts with disease progression (CNS metastases in 21.3% [19/89]), 79.1% (53/67) received ST and 52.2% (35/67) RT.
Conclusions
Hong Kong cohort shows that while 84.5% pts in CS I had Sx, majority in CS II (62.5%) and CS III (84.0%) received AT per guidelines while use of NT was limited. With mOS reducing from about 7 yrs (CS IA) to 3 yrs (CS IIIB) and a high recurrence rate (>75%), our results underscore need for integrating novel agents in both NT and AT settings with best Tx sequencing to improve prognosis of early-stage NSCLC.
Clinical trial identification
NCT04808050.
Editorial acknowledgement
Fortrea.
Legal entity responsible for the study
AstraZeneca International.
Funding
AstraZeneca International.
Disclosure
S.F. Nyaw: Non-Financial Interests, Personal and Institutional, Advisory Board: AstraZeneca International, Takeda. V.H.F. Lee: Financial Interests, Personal, Advisory Board: AstraZeneca, Amgen, Roche, Merck Sharp & Dohme, Boston Scientific, Takeda, ZaiLab; Financial Interests, Institutional, Research Grant: AstraZeneca, Boston Scientific. All other authors have declared no conflicts of interest.