Abstract 4579
Background
Late lines of therapy (LL) offered to cancer patients (pts) are often characterized by scarce or doubtful clinical benefit and literature evidences about their use and their real impact on survival and quality of life are very few. ESMO-MCBS (ESMO Magnitude of Benefit Scale) is a tool that gives an evaluation of the magnitude of clinically meaningful benefit that can be expected from anti-tumour therapies. The aim of our study was to evaluate ESMO-MCBS of the treatments that were offered as a LL to pts in our centre and to perform an evaluation of the clinical assistance they received.
Methods
We calculated ESMO-MCBS of the therapies that were offered as LL to pts that were treated at our centre and whose death happened in the period from January 1st, 2017 to December 31st, 2018. We also evaluated these pts’rate of unplanned access to emergency room or hospitalizations and their access to supportive care and palliative care service in the last 90 days of their lives.
Results
238 pts were included in the analysis. 12 (5.04%) pts received a LL with a high ESMO-MCBS (4 or 5), 16 (6.72%) a LL with an intermediate ESMO-MCBS, 77 (32.35%) a LL with a low ESMO-MCBS (1 or 2), and 133 (55.88%) a LL whose ESMO-MCBS could not be calculated because of lack of data from strong literature evidences (e.g. phase-3 trials) that are required for the scale. 79 pts (33.19%) had at least an unplanned access to emergency room or hospitalization during the last 90 days before death. 117 pts (49.16%) accessed at least once to our supportive and palliative care service in the same timeframe.
Conclusions
Our study confirmed that patients are often offered a LL whose clinical benefit is little, absent or unevaluable. Merely half of these pts are addressed to supportive/palliative care service whose clinical impact is high in this setting. On the one hand, we then strongly suggest integrating ESMO-MCBS as a clinical tool for the evaluation of possible LL offered to advanced-stage pts in order to prevent them from receiving therapies of poor clinical impact. On the other hand it becomes mandatory to offer these pts a timely access to valuable, more precocious supportive and palliative care, which can positively impact on their quality of life in the last months of their lives.
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.
Resources from the same session
2023 - Patients with brain metastases treated with afatinib in clinical practice – results from the prospective non-interventional study GIDEON
Presenter: Eckart Laack
Session: Poster Display session 1
Resources:
Abstract
1613 - Lerociclib (G1T38), an oral CDK4/6 inhibitor, dosed continuously in combination with osimertinib for EGFRmut non-small cell lung cancer: initial Phase 1b results
Presenter: David Berz
Session: Poster Display session 1
Resources:
Abstract
2853 - Real-world implementation of sequential targeted therapies for EGFR-mutated NSCLC
Presenter: Petros Christopoulos
Session: Poster Display session 1
Resources:
Abstract
1974 - A Phase II Open-Label, Multicentre Study to Assess the Anti-tumour Activity of Afatinib in Patients with Activating Epidermal Growth Factor Receptor mutation (EGFRm) from Circulating Tumor DNA (CtDNA)
Presenter: Young-Chul Kim
Session: Poster Display session 1
Resources:
Abstract
3370 - Influence of cow’s milk on the absorption and exposure of erlotinib in NSCLC patients
Presenter: Geerten Veerman
Session: Poster Display session 1
Resources:
Abstract
5900 - PTEN loss as Predictor of Tumor Heterogeneity (TH) and Poor Prognosis in EGFR-mutant Advanced Non-Small Cell Lung Cancer (ANSCLC) Patients (pts) Receiving Tyrosine-Kinase Inhibitors (TKIs).
Presenter: Miriam Ferrara
Session: Poster Display session 1
Resources:
Abstract
1302 - Safety of lorlatinib in subgroups of patients from a phase 1/2 trial
Presenter: Enriqueta Felip
Session: Poster Display session 1
Resources:
Abstract
1497 - Brigatinib (BRG) in Asian vs non-Asian patients (pts) with crizotinib (CRZ)-refractory ALK+ NSCLC in the phase 2 ALTA trial
Presenter: Dae Ho Lee
Session: Poster Display session 1
Resources:
Abstract
2349 - The safety assessment of crizotinib and alectinib from real world data of 840 ALK-inhibitor naïve patients with NSCLC harboring ALK-rearrangement (WJOG9516L).
Presenter: Kei Kunimasa
Session: Poster Display session 1
Resources:
Abstract
1120 - Brigatinib in ALK TKI-pretreated ALK+ metastatic non-small cell lung cancer (mNSCLC): the Use Via Expanded Access to Brigatinib (UVEA-Brig) study
Presenter: Silvia Novello
Session: Poster Display session 1
Resources:
Abstract