Abstract 1177P
Background
Stage III NSCLC comprises a heterogeneous population including large tumours invading surrounding tissues without lymph node metastases to small tumours with large lymph node metastases. Despite therapeutic advances, Stage III NSCLC is associated with a poor prognosis. MEA-KINDLE, as part of a real-world global study, evaluated treatment patterns and survival outcomes in patients with Stage III NSCLC in MEA.
Methods
Retrospective data were analysed from 33 centres in patients with Stage III NSCLC diagnosed between 01Jan2013 and 31Dec2017 with at least 9 months (m) of documented follow-up. Descriptive analyses included clinicodemographics and treatment patterns; inferential statistics evaluated the association of first-line treatment with progression-free survival (PFS) and overall survival (OS).
Results
The table shows the patient characteristics of MEA subset (Enrolled=1046). Table: 1177P
Baseline characteristics and treatment patterns
| Characteristics | Total (N=1046) |
| Median age (range), years | 61.0 (24-89) |
| Male* | 870 (83.2) |
| Current/ex-smokers* | 825 (80.8) |
| American Joint Committee on Cancer stage (7th ed.)* | |
| IIIA | 489 (58.9) |
| IIIB | 341 (41.1) |
| Adenocarcinoma* | 480 (47.8) |
| Eastern Cooperative Oncology Group ≤1* | 792 (88.6) |
| Epidermal growth factor receptor mutations (+ve/tested) | 35/175 |
| First-line treatment | Overall cohort (Stage IIIA, IIIB) (%) |
| Concurrent chemoradiotherapy (cCRT) | 32.3 (39.1, 31.9) |
| Chemotherapy (CT) | 19.6 (13.3, 18.8) |
| Sequential chemoradiotherapy (sCRT) | 12.1 (10.0, 16.9) |
| Radiotherapy | 8.9 (9.2, 10.5) |
| Surgery ± (neo)adjuvant | 16.1 (19.4, 5.8) |
*Values in n (%)
Median PFS (95% CI) was 11.8m (10.6, 12.4) for overall MEA subset (IIIA: 12.3m [11.4, 14.03]; IIIB: 10.1m [9.0, 11.8]). Median OS was 22.9m (21.2, 26.3) for overall MEA subset (IIIA: 27.5m [23.8, 33.7]; IIIB: 18.5m [17.4, 22.7]). OS was highest with surgery-based therapy (Sx)+CT (IIIA: 37.3m, IIIB: 24.1m) followed by cCRT (IIIA: 28.9m, IIIB: 24.4m). Female gender, adenocarcinoma histology, and cCRT or Sx+CRT in first-line were associated with higher OS (p<0.05).
Conclusions
The data reveal unmet needs in Stage III NSCLC as PFS and OS were worse in the MEA subset than in the global cohort. Better access to new therapies and quality care will be crucial in improving patient outcomes in MEA.
Clinical trial identification
NCT03725475, Sponsor indentifier: D133HR00004.
Editorial acknowledgement
Prajakta Nachane, M. Pharm from Covance Scientific Services & Solutions Pvt. Ltd., India for medical writing support that was funded by AstraZeneca FZ LLC.
Legal entity responsible for the study
AstraZeneca International.
Funding
AstraZeneca International UK.
Disclosure
A.R. Jazieh: Financial Interests, Personal and Institutional, Writing Engagements: AstraZeneca. E. Kaytan Saglam: Financial Interests, Personal and Institutional, Writing Engagements: AstraZeneca. Y. Abdelkader: Financial Interests, Personal, Writing Engagements: AstraZeneca. R. Gaafar: Financial Interests, Personal, Writing Engagements: AstraZeneca. E. Dawoud: Financial Interests, Personal, Writing Engagements: AstraZeneca. M. Nassar: Financial Interests, Personal, Writing Engagements: AstraZeneca. D. Alshorbagy: Financial Interests, Personal, Writing Engagements: AstraZeneca FZ LLC. H. El Ashry: Financial Interests, Institutional, Full or part-time Employment: AstraZeneca Gulf Cooperation Council. M. Alsayed: Financial Interests, Institutional, Full or part-time Employment: AstraZeneca International. All other authors have declared no conflicts of interest.