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
1443P - Patient-reported outcomes (PROs) with cemiplimab plus chemotherapy (CEMI + CHEMO) for first-line treatment of advanced non-small cell lung cancer (aNSCLC): PD-L1 level subgroups in EMPOWER-Lung 3
Presenter: Miranda Gogishvili
Session: Poster session 20
1444P - Sintilimab with two cycles nab-paclitaxel / platinum as first line therapy for advanced squamous non-small-cell lung cancer: The final analysis and biomarker results
Presenter: Huijuan Wang
Session: Poster session 20
1445P - A randomized phase III trial on Pembrolizumab Alone versUs pembrolizumab-chemotherapy in first LInE NSCLC (PAULIEN), results of the interim analysis
Presenter: Ilias Houda
Session: Poster session 20
1447P - IMscin001 part 2 updated results: Efficacy, safety, immunogenicity and patient-reported outcomes (PROs) from the randomised phase III study of atezolizumab (atezo) subcutaneous (SC) vs intravenous (IV) in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC)
Presenter: Mauricio Burotto
Session: Poster session 20
1449P - The preliminary data from a single-arm, open-label, multicenter phase II clinical trial: KN046 combined with axitinib as first-line (1L) treatment for NSCLC
Presenter: Yuanyuan Zhao
Session: Poster session 20
1450P - Addition of bevacizumab to first-line chemoimmunotherapy in NSCLC with liver metastases
Presenter: Matthieu Roulleaux Dugage
Session: Poster session 20
1451P - Identifying long-term responders to immune checkpoint blockade: Potential utility of serum proteomic profiling in metastatic non-small cell lung cancer
Presenter: Rafael Bach Mora
Session: Poster session 20
1452P - Factors associated with real-world (rw) outcomes among pts with metastatic NSCLC (mNSCLC) receiving select immuno-oncology (IO) regimens: CORRELATE
Presenter: Stephen Liu
Session: Poster session 20