945P - Respiratory and cardiometabolic comorbidities and stage I-III non-small cell lung cancer (NSCLC) survival: A pooled analysis from the International Lung Cancer Consortium (ILCCO)

Background

We explored the association of respiratory and cardiometabolic comorbidities with NSCLC overall survival (OS) and lung cancer specific survival (LCSS), by stage, in a large, international, multi-continent NSCLC pooled dataset.

Methods

Based on patients (pts) pooled from 11 separate ILCCO studies with available respiratory and cardiometabolic comorbidity data, adjusted Hazard Ratios (aHR) were estimated using Cox models for OS. LCSS was evaluated using competing risk Grey and Fine models and cumulative incidence functions. Logistic regression (adjusted odds ratio, aOR) was applied to assess factors associated with surgical resection.

Results

OS analyses utilized NSCLC pts with respiratory health or cardiometabolic health data (N=16,354); a subset (N=11,614) contributed to LCSS analyses. No associations with OS or LCSS were observed in Stage IV pts. For Stage I-III pts, there were associations with OS for respiratory (aHR 1.22, 95%CI: 1.15-1.30) and cardiometabolic comorbidities (aHR 1.09 CI: 1.01-1.18). With regard to LCSS, stage I-III NSCLC pts with respiratory comorbidities had worse LCCS when compared to those with no respiratory comorbidities (aHR 1.21, CI 1.09-1.34). In contrast, stage I-III NSCLC pts with cardiometabolic comorbidities had a higher risk of death from competing (non-NSCLC) causes (aHR 1.36, CI 1.15-1.63). The presence of respiratory comorbidities was inversely associated with having surgical resection (Stage I aOR 0.45 CI 0.35-0.59; Stage II/III aOR 0.66, CI 0.53-0.80).

Conclusions

The presence of either cardiometabolic or respiratory comorbidities is associated with significantly worse OS in Stage I-III NSCLC, but the reasons for each of these associations may be different. In our study, pts with respiratory comorbidities were less likely to undergo surgery and had worse LCSS, while pts with cardiometabolic comorbidities had a higher risk of death from competing causes. As more novel treatments options of Stage I-III NSCLC are introduced into practice, accounting for cardiometabolic and respiratory comorbidities becomes essential in trial interpretation and clinical management.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.