Abstract 1224P
Background
Lung cancer remains the leading cause of cancer-related death worldwide. In selected cases, treatment of resected Non-Small Cell Lung Cancer (NSCLC) requires in adjuvant chemotherapy. However, no guidelines are available for adjuvant chemotherapy in patients over 75 years-old by lack of dedicated studies. In this study, we assessed the benefit of adjuvant chemotherapy in patients over 75 years-old with NSCLC.
Methods
We conducted a single centre retrospective study in Marseille University Hospital based on the prospective EPITHOR database, including all patients over 75 years-old with NSCLC who underwent a complete lung anatomical surgical resection, with a theorical indication for adjuvant chemotherapy between January 2013 and July 2022. We compared survival outcomes of patients undergoing adjuvant chemotherapy or not. Primary outcome was 5 years disease-free survival (DFS) (Fine and Gray model, 5-years relapse rate being the competitive event) and secondary objectives was overall survival.
Results
129 patients were eligible for our study, 36 in the adjuvant chemotherapy group and 93 in the control group. Patients treated with adjuvant chemotherapy appeared to be younger, have a favourable perioperative course and a positive post-operative lymph node status. Adjuvant chemotherapy was significantly related to 5-years DFS in univariate analysis (HR=0.257 [95% CI: 0.080-0.819] p=0.0216) but not in multivariate analysis (HR=0.641 [95% CI: 0.144-1.473] p=0.191).Adjuvant chemotherapy was related to a lower mortality in univariate analysis (HR=0.567 [95% CI: 0.312-1.031] p=0.0631) but in multivariate analysis, chemotherapy did not seem to be related with cancer relapse or death (HR = 1.284 [95% CI: 0.72-2.28], p=0.40). Multivariate model included comorbidity index, age and VEMS.
Conclusions
Within daily care, oncologists tend to propose adjuvant chemotherapy on a patient-by-patient basis according to their post-operative lymph node status and comorbidities. This study provides a scientific basis for these choices and suggests that adjuvant chemotherapy benefit must be balanced considering specific geriatric comorbidities. Further studies will be needed to set up dedicated guidelines.
Clinical trial identification
PADS23-151.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A. Mogenet: Financial Interests, Institutional, Advisory Board: Pfizer, Takeda, AstraZeneca; Financial Interests, Institutional, Other, Travel fee: BMS; Financial Interests, Institutional, Invited Speaker: Takeda, Viatris. A. Couderc: Financial Interests, Institutional, Speaker, Consultant, Advisor: BMS, Ferrring, Nutricia, Amgen, Sanofi, GSK. P. Tomasini: Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, BMS, Lilly, Janssen, Amgen, Takeda; Financial Interests, Institutional, Local PI: Roche, AstraZeneca, Amgen, Lilly, Takeda; Financial Interests, Institutional, Coordinating PI: Janssen. L. Greillier: Financial Interests, Personal, Advisory Board: AbbVie, AstraZeneca, BMS, MSD, Novartis, Sanofi, Takeda, Roche; Financial Interests, Personal, Invited Speaker: Lilly, Pfizer; Financial Interests, Institutional, Local PI: AstraZeneca, AbbVie, BMS, MSD, Novartis, Takeda, Pfizer, Roche, PharmaMar; Financial Interests, Institutional, Coordinating PI: Sanofi. J. Pluvy: Financial Interests, Personal, Invited Speaker: Sanofi, Roche, Takeda, AstraZeneca, Viatris; Financial Interests, Personal, Advisory Board: Takeda, Sanofi. P.A. Thomas: Financial Interests, Institutional, Speaker, Consultant, Advisor: AstraZeneca, BMS, Roche, MSD, Amgen; Financial Interests, Institutional, Advisory Board: Ethicon. All other authors have declared no conflicts of interest.
Resources from the same session
1074TiP - A phase I study of GIGA-564, a minimally blocking anti-CTLA-4 monoclonal antibody
Presenter: James Gulley
Session: Poster session 04
1075TiP - A phase I trial of ATG-101, an investigational PD-L1×4-1BB bispecific antibody, in patients with advanced solid tumors and mature B cell non-Hodgkin lymphomas: PROBE-CN
Presenter: Junli Xue
Session: Poster session 04
Resources:
Abstract
1083P - KEYMAKER 02B: A randomized trial of pembrolizumab (pembro) alone or with investigational agents as first-line treatment for advanced melanoma
Presenter: Reinhard Dummer
Session: Poster session 04
1084P - Phase II study of AI-designed personalized neoantigen cancer vaccine, EVX-01, in combination with pembrolizumab in advanced melanoma
Presenter: Muhammad Khattak
Session: Poster session 04
1085P - Adoptive cell therapy with TCR gene-engineered T cells directed against MAGE-C2-positive melanoma: An ongoing phase I trial
Presenter: Brigit van Dijk
Session: Poster session 04
1086P - Intratumoral (IT) administration of autologous CD1c(BDCA-1)+/CD141(BDCA-3)+myeloid dendritic cells (myDC) with the immunologic adjuvant AS01B plus ipilimumab (IPI) and IV nivolumab (NIVO) in patients with refractory advanced melanoma: A phase Ib clinical trial
Presenter: Manon Vounckx
Session: Poster session 04
1087P - Phase II study of niraparib in patients with advanced melanoma with homologous recombination pathway gene mutations
Presenter: Kevin Kim
Session: Poster session 04
1088P - Molecular profiling and matched targeted therapy for patients with advanced melanoma: Results from part I of the MatchMEL study
Presenter: Andrea Boutros
Session: Poster session 04
1089P - Longitudinal biomarker analysis and outcomes for patients (pts) treated with neoadjuvant nivolumab (nivo) and relatlimab (rela) in surgically resectable melanoma
Presenter: Elizabeth Burton
Session: Poster session 04
Resources:
Abstract
1090P - High concurrent interferon gamma signature expression in the primary tumor and lymph node metastasis is associated with superior outcome upon neoadjuvant ipilimumab + nivolumab in stage III melanoma
Presenter: Lotte Hoeijmakers
Session: Poster session 04