Abstract 1352
Background
The best use of bone targeted agents (BTAs), i.e. how patients (pts) profit most from treatment, optimal timing of treatment start and frequency of administration as well as duration of treatment is unclear to date.
Methods
Physicians were asked to indicate the criteria they use for the indication and administration of BTAs in pts with bone metastases from solid tumors in Switzerland (physician-related outcomes, PO) during a period of 3 months. Patterns of care (POC) was assessed by questions about reasons for BTA administration, treatment pattern, patient characteristics, and actual treatment. Pts completed a pain and bone-pain related quality of life questionnaire.
Results
PO: Most of the physicians reported to start treatment with BTAs according to current guidelines (70.9%, 61/86). A smaller proportion would first assess the risk (high vs low) for developing skeletal-related events (SREs) to decide about treatment initiation (24.4%, 21/86). Factors contributing to define high risk were former SREs (89.5%, 77/86), lytic bone metastases (87.2%, 75/86), and high burden of disease (67.4%, 58/86), respectively. POC: The majority of the pts have been treated with BTAs immediately after the diagnosis of bone metastases (73.6%, 307/417). The main reasons for treatment with BTAs were high risk of bone complications (43%, 132/307), bone pain (21.8%, 67/307), and location of bone metastases (10.1%, 31/307), respectively. Denosumab was the most frequently used BTA (78.5%; 241/307), and a 3-4 week interval was most common (88.9%; 273/307). SREs were reported in 8.5% of treated vs 7.3% of non-treated pts, and were similar in pts rated as low or as high risk (about 8%).
Conclusions
The majority of the pts was treated according to current guideline recommendations with regard to start and interval of BTA treatment. The number of SREs was low irrespective of BTA treatment or risk classification for SREs, which may reflect a high impact of systemic cancer treatment on SRE reduction, or a selection of the pts according to risk factors not defined as the ones in the literature.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
SAKK.
Funding
Amgen.
Disclosure
M.T. Mark: Advisory / Consultancy: Roche; Advisory / Consultancy: MSD; Advisory / Consultancy: Böhringer Ingelheim; Advisory / Consultancy: Takeda; Advisory / Consultancy: BMS. B.J.K. Thuerlimann: Advisory / Consultancy, Travel / Accommodation / Expenses, Shareholder / Stockholder / Stock options: Roche; Shareholder / Stockholder / Stock options: Novartis; Advisory / Consultancy: Lilly; Advisory / Consultancy: Amgen; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Pfizer. R. von Moos: Advisory / Consultancy: amgen; Advisory / Consultancy: BMS; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Bayer; Advisory / Consultancy: Pfizer. All other authors have declared no conflicts of interest.
Resources from the same session
3317 - Circulating tumor DNA (ctDNA) analysis in patients (pts) with non-small cell lung cancer (NSCLC) treated with telisotuzumab vedotin (teliso-v), an antibody-drug conjugate targeting c-Met
Presenter: Rebecca Heist
Session: Poster Display session 1
Resources:
Abstract
3887 - First Real Life Data on Durvalumab after definitive concomitant ChemoRadiotherapy (cCRT) in unresectable Stage (St) III Non-Small Cell Lung Cancer (NSCLC) in France: Analysis of 591 patients (pts) enrolled in the French cohort (c) Temporary Authorization of Use (ATU)
Presenter: Virginie Avrillon
Session: Poster Display session 1
Resources:
Abstract
682 - EGFR Inhibitor Versus Chemotherapy as Adjuvant Treatment for Locally-advanced EGFR-mutant Non-Small Cell Lung Cancer
Presenter: Peng Xie
Session: Poster Display session 1
Resources:
Abstract
2509 - Afatinib in EGFR TKI-naïve patients with EGFR mutation-positive (EGFRm+) NSCLC: interim analysis of a Phase IIIb, multi-national, open-label study
Presenter: Filippo de Marinis
Session: Poster Display session 1
Resources:
Abstract
3300 - First-line ceritinib versus chemotherapy in patients (pts) with advanced ALK rearranged (ALK+) non-small cell lung cancer (NSCLC): ASCEND-4 Asian subgroup analysis
Presenter: Daniel SW Tan
Session: Poster Display session 1
Resources:
Abstract
2653 - A combined analysis of two Phase IIIb studies of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC
Presenter: Filippo de Marinis
Session: Poster Display session 1
Resources:
Abstract
3663 - Impact of plasma EGFR mutation fractions on response to first generation tyrosine-kinase inhibitor in treatment of naïve non-small cell lung cancer patients
Presenter: Xiaohong Wang
Session: Poster Display session 1
Resources:
Abstract
5921 - Definition of an afatinib trough concentration threshold in the treatment of NSCLC
Presenter: Stephane Bouchet
Session: Poster Display session 1
Resources:
Abstract
2852 - A Phase Ib Trial of Neoadjuvant Chemoradiotherapy and Durvalumab(MEDI4736) for Potentially Resectable stage III Non-Small Cell Lung Cancer (NSCLC)
Presenter: Beung chul AHN
Session: Poster Display session 1
Resources:
Abstract
3273 - Low expression of Notch1 and combined Notch1/HES1 are associated with adverse survival factor for limited stage small cell lung cancer
Presenter: Jinsoo Lee
Session: Poster Display session 1
Resources:
Abstract