Abstract 1842P
Background
In the last years, tumor genomic testing has drastically changed the prognosis of patients especially in those treated for an advanced/metastatic nonsquamous non–small-cell lung cancer (NSCLC). Lung cancer is associated with older age. However considering the heterogeneity of this population it remains unclear whether older patients are screened in the same proportion as younger patients. This study aims to compare the proportion of molecular testing performed in advanced or metastatic nonsquamous NSCLC at diagnosis between patients aged ≥ 70 years old, and their younger counterparts.
Methods
We conducted a retrospective analysis using the Epidemio-Strategy and Medical Economics (ESME) Advanced or Metastatic Lung Cancer (AMLC) Data Platform, a French multicenter real life database. All patients with an advanced or metastatic nonsquamous NSCLC diagnosed between 2015 and 2018 were selected. Molecular screening corresponded to, at least one mutation testing performed within 1 month before or 3 months after the AMLC diagnosis.
Results
In total, 2848 patients aged ≥ 70 yo (median age, 76 years) and 6900 patients < 70 yo were included in the analysis. Most of patients were male (63%). Median age at aNSCLC diagnosis was 64 yo. The proportion of current smokers at diagnosis was lower in the ≥ 70 yo group (17% vs 42%, p < 0.0001). Histological subtype was adenocarcinoma in 8074 (83%). There was no significant difference in the proportion of molecular testing performed between the two groups (63% vs 65%, p = 0.16). The proportion of molecular profiling performed at diagnosis increased over time in both groups. EGFR mutations were significantly more common in the older group (22% vs 12%, p < 0.0001) and KRAS mutations significantly more frequent in the younger group (37% vs 31% p < 0.0001). Distribution of others driver mutation (ALK, ROS1, BRAF V600E, HER2 and MET) was similar across age. In the multivariable analysis, factors associated with molecular testing were: female gender (OR1.26; 95%CI,1.13-1.41), adenocarcinoma (OR 2.36; 95%CI,2.08-2.67) and smoker status (OR 0.56; 95%CI,0.46-0.68).
Conclusions
Age is not a barrier to molecular testing in patients with advanced/metastatic non squamous NSCLC.
Clinical trial identification
Editorial acknowledgement
Members of the Scientific Group of the ESME platform and of the Esme Scientific Committee, Members of the Group of ESME Referents, Contributing Centers, the central coordination team and partners of the ESME platform.
Legal entity responsible for the study
R&D UNICANCER.
Funding
Has not received any funding.
Disclosure
D. Planchard: Non-Financial Interests, Personal and Institutional, Advisory Role: AstraZeneca; Non-Financial Interests, Personal and Institutional, Advisory Role: Bristol-Myers Squibb; Non-Financial Interests, Personal and Institutional, Advisory Role: Boehringer Ingelheim; Non-Financial Interests, Personal and Institutional, Advisory Role: Celgene; Non-Financial Interests, Personal and Institutional, Advisory Role: Eli Lilly; Non-Financial Interests, Personal and Institutional, Advisory Role: MSD Oncology; Non-Financial Interests, Personal and Institutional, Advisory Role: Novartis; Non-Financial Interests, Personal and Institutional, Advisory Role: Pfizer; Non-Financial Interests, Personal and Institutional, Advisory Role: PriME Oncology; Non-Financial Interests, Personal and Institutional, Advisory Role: Roche; Non-Financial Interests, Personal and Institutional, Advisory Role: Merck; Non-Financial Interests, Personal and Institutional, Advisory Role: Daiichi Sankyo; Financial Interests, Personal, Other, Honoraria: AstraZeneca; Financial Interests, Personal, Other, Honoraria: Bristol-Myers Squibb; Financial Interests, Personal, Other, Honoraria: Boehringer Ingelheim; Financial Interests, Personal, Other, Honoraria: Celgene; Financial Interests, Personal, Other, Honoraria: Eli Lilly; Financial Interests, Personal, Other, Honoraria: Novartis; Financial Interests, Personal, Other, Honoraria: PriME Oncology; Financial Interests, Personal, Other, Honoraria: Peer CME; Financial Interests, Personal, Other, Honoraria: Roche. M. Bringuier: Financial Interests, Personal, Other, Honoraria: Lilly; Non-Financial Interests, Personal, Other, Travel, accomodations, expenses: Pfizer; Non-Financial Interests, Personal, Other, Travel, accomodations, expenses: MundiPharma. B. Besse: Financial Interests, Institutional, Funding: AbbVie; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Funding: Boehringer Ingelheim; Financial Interests, Institutional, Funding: Celgene; Financial Interests, Institutional, Funding: Cristal Therapeutics; Financial Interests, Institutional, Funding: Eli Lilly; Financial Interests, Institutional, Funding: Janssen; Financial Interests, Institutional, Funding: Merck KGaA; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Sanofi; Financial Interests, Institutional, Funding: Spectrum Pharmaceuticals; Financial Interests, Institutional, Funding: Tiziana Pharma; Financial Interests, Institutional, Funding: Takeda; Financial Interests, Institutional, Funding: Amgen; Financial Interests, Institutional, Funding: Blueprint Medicines; Financial Interests, Institutional, Funding: BMS; Financial Interests, Institutional, Funding: GSK; Financial Interests, Institutional, Funding: Ipsen; Financial Interests, Institutional, Funding: OSE Immunopharmaceutics. M. Pérol: Financial Interests, Personal, Advisory Role: Roche; Financial Interests, Personal, Advisory Role: Eli Lilly; Financial Interests, Personal, Advisory Role: Boehringer Ingelheim; Financial Interests, Personal, Advisory Role: Pfizer. N. Girard: Financial Interests, Personal and Institutional, Other, consultancy fees: AstraZeneca; Financial Interests, Personal and Institutional, Other, consultancy fees: Bristol-Myers Squibb; Financial Interests, Personal and Institutional, Other, consultancy fees: Hoffman-La-Roche; Financial Interests, Personal and Institutional, Other, consultancy fees: Merck Sharp and Dohme; Financial Interests, Personal and Institutional, Other, consultancy fees: Pfizer. C. Ricordel: Financial Interests, Personal, Advisory Role: BMS. D. Debieuvre: Financial Interests, Personal and Institutional, Research Grant: Roche; Financial Interests, Personal and Institutional, Research Grant: BMS; Financial Interests, Personal and Institutional, Research Grant: Pfizer; Financial Interests, Personal and Institutional, Research Grant: AstraZeneca; Financial Interests, Personal and Institutional, Research Grant: Chugaï; Financial Interests, Personal and Institutional, Research Grant: Lilly; Financial Interests, Personal and Institutional, Research Grant: Novartis; Financial Interests, Personal and Institutional, Research Grant: MSD; Financial Interests, Personal and Institutional, Research Grant: Boehringer Ingelheim; Financial Interests, Personal and Institutional, Research Grant: Chiesi; Financial Interests, Personal and Institutional, Research Grant: Janssen; Financial Interests, Personal and Institutional, Research Grant: GSK; Financial Interests, Personal and Institutional, Research Grant: Sandoz; Financial Interests, Personal, Other, Travel, accomodations, expenses: MundiPharma; Financial Interests, Personal, Other, Travel, accomodations, expenses: Pierre Fabre. C. Baldini: Non-Financial Interests, Personal and Institutional, Invited Speaker: Sanofi; Non-Financial Interests, Personal and Institutional, Invited Speaker: BMS; Non-Financial Interests, Personal and Institutional, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Other, institutional research support as local PI: Seattle Genetics; Financial Interests, Institutional, Other, institutional research support as local PI: Iteos; Financial Interests, Institutional, Other, institutional research support as local PI: Tahio; Financial Interests, Institutional, Research Grant: BMS. All other authors have declared no conflicts of interest.