1420P - Real-life management of octogenarians with NSCLC in a French nationwide cohort

Background

Due to scarce publications, no specific recommendations have been published for the management of octogenarians with NSCLC. In a real-life prospective observational, multicenter study we analyze their clinical and biological characteristics, modalities of treatments by stage, overall survival (OS) and its evolution in ten years.

Methods

Between 01/01 and 12/31/2020, all patients diagnosed with a Lung Cancer (LC) in 82 participating centers, were included in a nationwide cohort (KBP-2020). Here, we report data on octogenarians with NSCLC compared to those under 80 y.o (<80). OS was calculated using the Kaplan-Meier method. Management and OS were compared to the previous cohort (KBP-2010).

Results

8,999 LC were included in KBP-2020, 1026 (11.4%) were NSCLC over 80 y-o. Median age was 83.7, 33.7% were female, 40.0% had a PS≥2 (vs 21.9% in <80), 61.2% had lost weight (mean 6.8kg) at diagnosis (vs 53.2% in <80), 32.2% were non-smokers (vs 10.8 % in <80), 62.7% had an adenocarcinoma. By stage, there were 19% localized (N=188), 18.8% locally advanced (N=186) and 62.2% metastatic (N=615) disease. Biomolecular analysis was performed in 65% of cases. Table: 1420P

Compared to KBP-2010, in octogenarians, surgery was performed in 46.3% of localized disease (vs 26%), thoracic radiotherapy or chemotherapy in 33.3% (vs 25.5%) and 38.9% (vs 41.5%), respectively of locally advanced disease and systemic therapy was given in 55.7% of metastatic disease (vs 52.1%). Chemotherapy, targeted therapy or immunotherapy were performed in 25.4%, 18.2% and 14.9% of metastatic patients, respectively. In 2020, median OS for all NSCLC octogenarians was 8.7 months [7.0 - 9.9] vs 5.0 months [4.6 - 5.8] in 2010.

Conclusions

Compared to youngest patients, octogenarians more often had a PS≥2, lost weight, were non-smokers, had an EGFR or a MET exon 14 mutation. Compared to 2010, in 2020 surgery was performed more frequently as targeted therapy and immunotherapy while chemotherapy was less often offered resulting in better OS.

Clinical trial identification

NCT04402099.

Editorial acknowledgement

Legal entity responsible for the study

CPHG (Collège des Pneumologues des Hôpitaux Généraux).

Funding

The present study was promoted by the French College of General Hospital Pulmonologists (CPHG) with the endowment funds of Fondation du Souffle, Le Nouveau Souffle, Couleur espoir, the labeling of InCa (Institut national du Cancer) and FHF-CNR, and financial support of following laboratories: AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Chugai, Janssen, MSD, Lilly, Pfizer, Roche, Sanofi and Takeda.

Disclosure

J.B. Auliac: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, Roche, Sanofi, Takeda; Financial Interests, Personal, Invited Speaker: BMS, Amgen, AstraZeneca, Sanofi, Boehringer. J. Pinsolle: Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Other: Pfizer. D. Debieuvre: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Janssen, Pfizer, Ose Immunotherapeutics, Novartis, SanofiAventis, Amgen, Roche, Ipsen; Financial Interests, Personal, Invited Speaker: Gilead, Takeda, Pfizer; Financial Interests, Institutional, Funding: Roche, AstraZeneca, Janssen, MSD, Pfizer, BMS, Lilly, Boehringer Ingelheim, GSK, Chugaï, Chiesi, Novartis, Takeda, Bayer, SanofiAventis. All other authors have declared no conflicts of interest.