Abstract 935P
Background
This retrospective study describes demographics, clinical characteristics, treatment (Tx) patterns and clinical outcomes of resected patients (pts) diagnosed with Stages (S) I–III non-small-cell lung cancer (rNSCLC) without known EGFR mutations in the US CancerLinQ database.
Methods
Pts diagnosed with SI-III NSCLC from 1 Jan 2014 to 31 Aug 2020 who underwent resection within 140 d after initial diagnosis were included and followed for survival and recurrence until their last recorded clinical visit, death or 31 Aug 2021 (data cutoff). The following Tx patterns were identified: surgery only (SO), neoadjuvant therapy + surgery (NT), surgery + adjuvant therapy (AT) and neoadjuvant + surgery + adjuvant therapy (NAT).
Results
3329 pts met the study criteria. Median age at diagnosis was 68 yr (range 24–91). Among 2424 pts with known smoking status, 89.4% were current/former smokers. Of 1565 pts with comorbidity data, 59.9% had ≥1 comorbidity using the Elixhauser index. 54.7% were SI, 29.3% SII and 16.0% SIII. Across SI–III, 71.6% had SO, 25.2% had AT, 1.9% had NT and 1.4% had NAT; 51.5% of SII and 42.9% of SIII pts had SO. Surgery included lobectomy (74.7%), wedge resection (14.6%), pneumonectomy (5.0%), bilobectomy (3.4%) or segmentectomy (2.3%). Of pts with AT, most received chemotherapy only (75.2%), chemoradiotherapy (15.4%) or radiotherapy only (7.5%), while only 1.0% received immunotherapy (IO) at all. Kaplan-Meier estimated survival at 5 yr was 65.4% (95% CI: 63.0–67.7) across all stages, 72.6% (95% CI: 69.4–75.5) for SI, 61.6% (95% CI: 57.1–65.8) for SII and 47.9% (95% CI: 42.1–53.6) for SIII.
Conclusions
In contrast to NCCN recommendations for systemic therapy of pts with early-stage disease, nearly half of either SII or SIII rNSCLC pts received SO in this study. Of those treated with systemic therapy, the majority received AT of whom most received chemotherapy only. This study describes US clinical practice in the rNSCLC landscape, prior to the introduction of neo/adjuvant and perioperative IO. Effective multidisciplinary team management of pts may increase use of systemic Tx for eligible pts, helping to improve pt outcomes.
Clinical trial identification
Editorial acknowledgement
Medical writing support for the development of this abstract, under the direction of the authors, was provided by Andrew Gannon of Ashfield MedComms (New York, NY), an Ashfield Health company.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
N.K. Altorki: Financial Interests, Institutional, Research Grant: Janssen; Financial Interests, Institutional, Principal Investigator, Clinical trial: AstraZeneca. R. Salomonsen: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. N.E. Georgoulia: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Ownership Interest: AstraZeneca. I. Diaz Perez: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Ownership Interest: AstraZeneca. A. Wang: Financial Interests, Personal and Institutional, Full or part-time Employment: AstraZeneca. L. Cai: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. G. Wetherill: Financial Interests, Personal and Institutional, Full or part-time Employment, Contractor: AstraZeneca. Y. Xiao: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. C. Fielden: Financial Interests, Personal, Other, Contractor: AstraZeneca. J.E. Gray: Financial Interests, Personal, Invited Speaker, Consultant: AstraZeneca & Jazz Pharmaceutical, IASLC 2020 NACLC, IASLC 2020 WCLC, Merck Sharp & Dohme, 2021 AACI/CCAF Annual Meeting, OncLive Strategic Alliance-Inst Perspective in Cancer: Lung, 2021 Atlanta Lung Cancer Symposium, IASLC 2020 TTLC, Eli Lilly, Blueprint Medicine; Financial Interests, Personal, Advisory Board, ADAURA Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board, 2020 Innovations Onc Adv Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board, Global Thor Adv Board: Lilly/Loxo Oncology; Financial Interests, Personal, Advisory Board, CEACAM5 Lung Cancer Adv Council: Sanofi; Financial Interests, Personal, Advisory Board, North America Tepotinib Lung Adv Board: EMD Serono; Financial Interests, Personal, Advisory Board, Diversity in Clinical trials External Adv Board: Eli Lilly; Financial Interests, Personal, Advisory Board, Lung Med Onc Adv Council: AZ-IO; Financial Interests, Personal, Advisory Board, KEYLYNK 006 & 008 Scientific Adv Board: Merck Sharp & Dohme; Financial Interests, Personal, Advisory Board, Scientific Adv Board: Janssen; Financial Interests, Personal, Advisory Board: Daiichi Sankyo, 2021 Atlanta Lung Ca Symposium Oncocyte, Blueprint Medicine, NCCN AZ Small Cell Lung Cancer RFPDT; Financial Interests, Personal, Advisory Board, NSCLC &SCLC Adv Board: AZ UK Limited; Financial Interests, Personal, Member of the Board of Directors: IASLC; Financial Interests, Institutional, Funding: AstraZeneca, Boehringer Ingelheim, ECOG-ACRIN, Genentech, G1 Therapeutics, Ludwig Inst for Cancer Research, Merck & Co, Novartis, Pfizer, SWOG/Alliance for Clin Trials in Onc, Bristol Myers Squibb; Financial Interests, Institutional, Principal Investigator: AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, ECOG-ACRIN, Genentech, G1 Therapeutics, Ludwig Inst for Cancer Research, Merck & Co, Novartis, Pfizer, SWOG/Alliance for Clin Trials in Onc; Financial Interests, Personal, Member: ASCO, SWOG, IASLC, AACR, FLASCO; Financial Interests, Personal, Leadership Role, Chair: SWOG Lung Committee, ASCO Education Program, Moffitt Cancer Center Thoracic Oncology Department.