3124 - Does Progress achieved in the Treatment of Patients with Metastatic Non-Small-Cell Lung Cancer (NSCLC) reach the Elderly Population?

Background

Although treatment modalities for non-small cell lung cancer (NSCLC) are rapidly evolving, there is insufficient evidence that novel drugs reach elderly patients (aged ≥ 70 years) and improve their outcomes. The purpose of this study was to evaluate the access to treatment in the elderly population with stage IV NSCLC in a real life setting and its impact on survival (OS) over the past 10 years.

Methods

We compared elderly and younger patients with stage IV NSCLC treated at our tertiary cancer centre and its affiliated smaller hospitals. We collected patients and tumor characteristics such as age at diagnosis, gender, smoking history, histology, molecular subtyping, PDL1 expression status and data on treatment types as well as lines. We grouped the enrolled patients into four same size cohorts based on time and age at diagnosis: patients diagnosed 2005-2007 (elderly cohort-I) and 2015-2016 (elderly cohort-II) were compared to cohorts of patients <70 years old diagnosed during the same time periods (young cohorts-I and -II). The characteristics were analysed using Chi-square Test and survival related endpoints with Kaplan-Meier model. A log-rank test was used to test the equality of the survivor functions and a z-Test to assess the differences in survival proportions.

Results

499 NSCLC cases were retrospectively analysed. Median OS significantly improved in both, the elderly and the young cohorts, over time. OS in the elderly cohort-I and -II was slightly lower (3.7 months and 5.3 months) compared to the young cohorts-I and -II (7.8 and 12.1 months). In the young group 12-months OS was significantly improved over the last 10 years (34% [95%CI 27%-42%] and 52% [95%CI 43%-61%], p = 0.049). There was no significant improvement in the elderly cohorts (18% [95%CI 11%-25% vs. 31% [95%CI 22%-39%], p = 0.29). Therapy with any line of systemic treatment modalities remained lower in the elderly cohorts as compared to younger patients (53% versus 78%).

Conclusions

We observed a significant improvement in OS over the past 10 years in young patients, whereas a similar benefit was not found for the elderly. Our findings highlight a strong need in studying this growing population separately in elderly specific clinical trials.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

S. Schmidt: Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: MSD; Research grant / Funding (institution): BMS; Research grant / Funding (institution): AstraZeneca; Travel / Accommodation / Expenses: MSD; Travel / Accommodation / Expenses: TAKEDA; Travel / Accommodation / Expenses: Boehringer Ingelheim. M. Fruh: Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Roche; Advisory / Consultancy: Takeda. All other authors have declared no conflicts of interest.