Abstract 1420P
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
Gene | EGFR | KRAS G12C | MET ex14 | BRAF V600E | HER2 | RET | ALK | ROS1 | ||||||||
N+/ N tested | % | N+/ N tested | % | N+/ N tested | % | N+/ N tested | % | N+/ N tested | % | N+/ N tested | % | N+/ N tested | % | N+/ N tested | % | |
NSCLC ≥80 y | 141/553 | 25.5 | 52/381 | 13.6 | 25/219 | 11.4 | 14/364 | 3.8 | 9/293 | 3.1 | 2/69 | 2.9 | 11/559 | 1.9 | 7/488 | 1.4 |
NSCLC <80 y | 379/3426 | 11.1 | 520/2741 | 19.0 | 39/1616 | 2.4 | 81/2553 | 3.2 | 35/2013 | 1.7 | 10/561 | 1.8 | 94/3923 | 2.4 | 61/3365 | 1.8 |
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.
Resources from the same session
1401P - Impact of KRAS mutation on non-small cell lung cancer survival outcomes
Presenter: Quentin Thomas
Session: Poster session 20
1402P - Real-world routine KRAS testing practices in France for patients (pts) with advanced or metastatic (AM) non-small cell lung cancer (NSCLC): Data from the ESME cohort
Presenter: Clarisse Audigier Valette
Session: Poster session 20
1403P - Sotorasib in KRAS p.G12C mutated advanced NSCLC: Real-word data from the Italian Expanded Access Program
Presenter: Maria Lucia Reale
Session: Poster session 20
1404P - Clinical characteristics and therapeutics sequences of KRAS G12C metastatic non-small cell lung cancer (mNCSLC) patients treated by sotorasib in the French pre-marketing authorization (MA) early access program (cohort temporary authorization of use, cATU)
Presenter: Herve Lena
Session: Poster session 20
1405P - Sotorasib in KRAS G12C-mutated NSCLC: A multicenter real-world experience from the expanded access program in Germany
Presenter: Friederike Althoff
Session: Poster session 20
1406P - Outcomes of patients with metastatic EGFR mutant lung cancer requiring dose modifications of first line osimertinib
Presenter: J. Connor Wells
Session: Poster session 20
1407P - Characteristics and treatment sequences of patients (pts) with KRAS G12C, other KRAS and non-KRAS advanced or metastatic (AM) non-small cell lung cancer (NSCLC) in the French ESME cohort
Presenter: Nicolas Girard
Session: Poster session 20
1408P - Differences on immune biomarkers between KRAS G12C and KRAS non-G12C mutated non-small cell lung cancer
Presenter: Laura Masfarre Pinto
Session: Poster session 20
1409P - DEnosumab in combination with PD-1 checkpoint blockade for MAINtenance therapy of KRAS-mutant advanced NSCLC after first-line immunotherapy: A prospective, single-arm, phase II trial (DEMAIN)
Presenter: Hong-Shuai Li
Session: Poster session 20
1410P - Characterization of patients with advanced non-small-cell lung cancer (NSCLC) harboring KRASG12C mutation and their associated direct healthcare costs in Spanish routine clinical practice (SILK study)
Presenter: Noemi Reguart Aransay
Session: Poster session 20