Abstract 2660
Background
MPM is a highly aggressive pleural tumor associated with asbestos exposure and with limited survival despite systemic therapy. The incidence of MPM in elderly is increasing and these patients (p) require special consideration due to multiple comorbidities and increased risk of toxicities. The objective of this study is to characterize elderly p diagnosed with MPM at our institution and evaluate overall survival in this population.
Methods
One hundred forty-seven MPM p diagnosed at Vall d´Hebron Institute of Oncology between November 2002 and December 2016 were reviewed. Associations between clinical variables and outcome were assessed with Cox regression models and survival data were calculated by the Kaplan-Meier method.
Results
Patient’s characteristics: median age 68 years (y) (51-86 years), males: 70%, performance status (PS)1: 67%, asbestos exposure: 72%, epithelioid subtype: 73%. First line chemotherapy was offered to 83% of p (73% cisplatin-pemetrexed and 21% carboplatin-pemetrexed). Median progression free survival (PFS) first line was 4.9 months (m;CI95% 3.6-5.6). Clinical trial was offered as second-line regimen in 34%. Median survival (OS) in overall population was 16.8 m (95%CI13.2-22.2) and in those treated with chemotherapy was 20.6 m (95%17.1-23.6). Epitheliod histology, PS 0, neutrophil-lymphocyte ratio >5 and treatment with cisplatin vs carboplatin were associated with significant improvements in OS. In total, 59 p were >70y, 42 p > 75y and 19 p > 80y. Elderly p (>70y) received first line in 66% of cases, with carboplatin-pemetrexed in 76%. Median PFS in first line was 4.8 m (95%CI 3.7-4.7m). No differences in treatment discontinuation by toxicity neither dose reductions were found (6% vs 4% and 6 vs 7% in elderly vs < 70y, respectively). Second line was given in 42% of elderly. Median OS in elderly p receiving chemotherapy was 15.1 m vs 2.7 m with best supportive care (p < 0.001). Epithelioid histology, PS 0 and eligibility to first line chemotherapy were significant prognostic factors in elderly p (p < 0.001).
Conclusions
In our real world experience, chemotherapy was feasible in most elderly p with MPM and does not associates with inferior outcomes or higher toxicity compared to younger population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Cedres: Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: Bristol-Myers Squibb; Speaker Bureau / Expert testimony: Boehringer Ingelheim; Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer; Speaker Bureau / Expert testimony: Apmhera; Advisory / Consultancy: Lilly; Honoraria (institution): Merck. P. Iranzo: Advisory / Consultancy: Roche; Advisory / Consultancy: Grunenthal; Advisory / Consultancy, Travel / Accommodation / Expenses: Kyowa Kirin; Advisory / Consultancy: Rovi; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy, Travel / Accommodation / Expenses: Pierre Fabre. A. Callejo: Advisory / Consultancy: Roche ; Advisory / Consultancy: Pfizer; Travel / Accommodation / Expenses: MSD; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Bristol-Myers Squibb. N. Pardo: Advisory / Consultancy, Travel / Accommodation / Expenses: roche; Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Bristol Myers Squibb. A. Navarro: Advisory / Consultancy: Roche; Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer; Advisory / Consultancy, Travel / Accommodation / Expenses: Boehringer Ingelheim; Advisory / Consultancy: Bristol-Myers Squibb ; Speaker Bureau / Expert testimony: Orizon Genomics. A. Martinez-Marti: Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Roche ; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy: Pfizer; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Boehringer Ingelheim ; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Bristol-Myers Squibb; Advisory / Consultancy, Travel / Accommodation / Expenses: Merck Sharp. R. Dienstmann: Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Advisory / Consultancy: Novartis; Speaker Bureau / Expert testimony: Symphogen; Speaker Bureau / Expert testimony: Ipsen; Speaker Bureau / Expert testimony: Amgen; Speaker Bureau / Expert testimony: Sanofi; Speaker Bureau / Expert testimony: MSD; Speaker Bureau / Expert testimony: Servier; Research grant / Funding (institution): Merck. E. Felip: Advisory / Consultancy, Speaker Bureau / Expert testimony: Abbvie; Advisory / Consultancy, Speaker Bureau / Expert testimony: AstraZeneca; Advisory / Consultancy: Blue Print Medicines; Advisory / Consultancy, Speaker Bureau / Expert testimony: Boehringer Ingelheim; Advisory / Consultancy: Celgene; Advisory / Consultancy, Speaker Bureau / Expert testimony: Eli Lilly; Advisory / Consultancy: guardant health ; Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck KgaA; Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck, Sharp and Dohme; Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Advisory / Consultancy, Speaker Bureau / Expert testimony: Takeda; Advisory / Consultancy: Janssen. All other authors have declared no conflicts of interest.
Resources from the same session
3683 - Impact of Radiotherapy on efficacy of anti-programmed death 1 (PD-1) antibodies in metastatic NSCLC
Presenter: Evangeline Samuel
Session: Poster Display session 1
Resources:
Abstract
3924 - Pembrolizumab frontline monotherapy in patients with NSCLC and high PD-L1 expression: Real World Data from a European Cohort with focus on subgroups of interest
Presenter: Giannis Mountzios
Session: Poster Display session 1
Resources:
Abstract
3970 - Patients with metastatic non-small cell lung cancer and PD-L1 expression in Germany. Treatment and first outcome from the prospective German Registry Platform CRISP (AIO-TRK-0315)
Presenter: Martin Sebastian
Session: Poster Display session 1
Resources:
Abstract
5350 - The efficacy and safety of pembrolizumab as a first-line therapy in PD-L1 50% positive advanced NSCLC (HOPE-001)
Presenter: Motohiro Tamiya
Session: Poster Display session 1
Resources:
Abstract
3832 - Osimertinib in epidermal growth factor receptor (EGFR) T790M advanced non-small cell lung cancer (NSCLC): analysis of patients with central nervous system (CNS) metastases in a real-world study (ASTRIS)
Presenter: Giulio Metro
Session: Poster Display session 1
Resources:
Abstract
4082 - Real-world (RW) treatment patterns and outcomes for second-line (2L) therapy and beyond in patients (pts) with epidermal growth factor receptor-mutated (EGFRm) advanced NSCLC receiving a first-line (1L) first- or second-generation (1G/2G) EGFR tyrosine kinase inhibitor (TKI)
Presenter: Riyaz Shah
Session: Poster Display session 1
Resources:
Abstract
2855 - Impact of ramucirumab (RAM) + erlotinib (ERL) on EGFR mutations in circulating tumor DNA – The 1st report of a biomarker study in Japanese patients from RELAY: Global Ph3 study of ERL + RAM or placebo (PL) in 1L metastatic NSCLC with EGFR activating mutations
Presenter: Kazuto Nishio
Session: Poster Display session 1
Resources:
Abstract
2911 - Apatinib combined with EGFR - TKI in treating advanced non-small cell lung cancer with EGFR - TKI resistance
Presenter: Ruifen Tian
Session: Poster Display session 1
Resources:
Abstract
2100 - Updated analysis of a phase I trial of afatinib (Afa) and bevacizumab (Bev) in chemo-naïve patients (pts) with advanced non-small-cell lung cancer (NSCLC) harboring EGFR-mutations: OLCSG1404
Presenter: Takashi Ninomiya
Session: Poster Display session 1
Resources:
Abstract
4325 - Multiple synchronous mechanisms may contribute to osimertinib resistance in non-small cell lung cancer (NSCLC) patients: insights of the MATCH-R study
Presenter: Diego Enrico
Session: Poster Display session 1
Resources:
Abstract