ESMO Asia Virtual Congress 2020

Abstract 371P

Background

Heterogeneous nature and poor prognosis of stage III NSCLC, accounting for ≈29% of NSCLC burden, cause substantial management challenges in India. We present the results of Indian cohort from the real-world, multicountry, observational KINDLE study that explored treatment patterns and associated outcomes in the pre-immuno-oncology era.

Methods

Retrospective data from 15 sites in India were analyzed for stage III NSCLC patients diagnosed between 01Jan2013 and 31Dec2017 with at least 9 months (m) of documented follow-up. Descriptive analyses for demographics, clinical characteristics, and treatment modalities, and inferential statistics to correlate treatment with progression-free survival (PFS) and overall survival (OS) were conducted.

Results

Data for 494 patients: median age 60.0 years (range 25-84), 83.4% men, 58.7% current/former smokers, and 48.2% and 51.8% with stage IIIA and IIIB NSCLC (AJCC 7^th ed.), respectively; 84.9% had ECOG performance score of 0/1 at diagnosis. Squamous cell and adenocarcinoma represented 48.5% and 44.6%, respectively; 15.4% had EGFR mutations. Of the 18 first-line treatment modalities, the most frequent were concurrent chemoradiotherapy (cCRT) (29.5%), sequential CRT (13.6%), chemotherapy (CT) alone (13.3%), and radiotherapy alone (12.7%). Overall median PFS was 16.4m, 95% confidence interval (CI) 14.36-19.38 (stage IIIA: 19.4m, 95% CI 15.08-25.95; IIIB: 15.4m, 95%CI 12.45-19.78). Overall median OS was 66m, 95% CI 49.81-noncalculable (NC); (stage IIIA: NC, 95% CI 52.14-NC; IIIB 66.0m, 95% CI 36.04-NC). In stage IIIA patients, cCRT was associated with longer OS than CT alone (64.1m vs. 30.0m, p=0.0493). Among stage IIIB patients, cCRT was associated with significantly higher OS than CT alone (66.0m vs. 22.6m, p=0.0226).

Conclusions

The India data reveal varied treatment modalities in stage III NSCLC. Overall median PFS and OS were better for India (16.4m and 66m) than in the global cohort (12.5m and 34.9m). cCRT was associated with improved survival in both stage IIIA and IIIB. Improved access to newer medicines and quality care will be key to further enhance patient outcomes.