Abstract 1252P
Background
The more precise 8th TNM classification and recent innovations in management of stage III NSCLC are leading to an increase in more personalized therapeutic options. Here, we describe the characteristics, treatments and survival of stage III patients included in a French nationwide cohort in 2020.
Methods
KBP is a Real-World French prospective study on Lung Cancer (LC) conducted in non-academic public hospitals (NPH). During the year 2020, all patients (pts) diagnosed with a Lung Cancer (LC) in 82 participating centers, the characteristics of the 8 999 patients included have already been reported.
Results
Among the pts included in KBP study with NSCLC, 1524 (20.1%) are diagnosed at stage III distributed into IIIA: 692 (45.4%), IIIB: 598 (39.2%), IIIC: 234 (15.4). 774 patients (50,7%) are classified at stage IIIN2 (39% IIIA and 61.0% IIIB). The mean age is 68.5 y. Mutation research is performed in 52.8% (805/1524), a PD-L1 analysis in 91.8% (1399/1524). The distribution of treatments is detailed in the table. Median OS is significantly better whatever the 1L treatment in stage IIIA 31.0 months [27.3 - 35.7] than IIIB and IIIC with respectively 20.4 [18.2 - 25.0] and 16.1 [13.5 - 20.7] months. Overall survival is significantly better for patients benefiting surgery (S), the 3y OS in stage IIIA is 62.9% [57.1 - 69.2] and in III B/C 55.8% [46.4 - 67.0] compared to patients receiving radiotherapy (RT) 39.2% [32.9 - 46.7] and 42.5% [37.4 - 48.1] or only systemic treatments (ST) 33.8% [26.9 - 42.6] and 23.3% [18.7 - 29.0]. Among N2 patients, surgery is also associated with a better prognosis than radiotherapy without surgery or systemic treatment alone (respectively 62.0% [55.2 - 69.7], 45.6% [40.3 - 51.6] and 25.5% [19.7 - 33.1]). Table: 1252P
IIIA 647 | IIIB/C 782 | P | |||
Surgery | 253 | (39.1) | 92 | (11.8) | |
S only | 52 | (20.6) | 26 | (28.3) | 0.17 |
S + RT | 40 | (15.8) | 15 | (16.3) | 1 |
S + CT | 188 | (74.3) | 62 | (67.4) | 0.26 |
S + IO | 12 | (4.7) | 3 | (3.3) | 0.77 |
S + TT | 0 | (0.0) | 2 | (2.2) | 0.071 |
M. OS (mth) | 47.6 [43.5 - NA] | 41.2 [32.6 - NA] | |||
RT (w/o S) | 202 | (31.2) | 339 | (43.4) | |
RT + CT | 181 | (89.6) | 318 | (93.8) | 0.11 |
RT + IO | 50 | (24.8) | 75 | (22.1) | 0.55 |
RT + TT | 0 | (0.0) | 2 | (0.6) | 0.53 |
M. OS (mth) | 26.1 [21.6 - 32.1] | 27.9 [22.9 - 34.1] | |||
ST (w/o S, w/o RT) | 143 | (22.1) | 280 | (35.8) | |
CT | 121 | (84.6) | 233 | (83.2) | 0.82 |
IO | 41 | (28.7) | 110 | (39.3) | 0.04 |
TT | 8 | (5.6) | 15 | (5.4) | 1.00 |
M. OS (mth) | 25.0 [19.1 - 29.2] | 13.1 [9.9 - 15.7] |
CT = chemotherapy, IO = immunotherapy, TT = targeted therapy, M. OS = Median overall survival, w/o = without, Mths = months
Conclusions
Many multimodalities therapeutic approaches are proposed in Stage III NSCLC, the analysis of this real-life study reflects the heterogeneous nature of stage III and the importance of a personalized approach.
Clinical trial identification
Editorial acknowledgement
The authors would like to thank Margaux Orange (Catherine Thiriet, Alizée Petit and Alexia Letierce) for their help in preparing this article.
Legal entity responsible for the study
CPHG (Collège des Pneumologues des hopitaux 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 French Hospital Federation-CNR, and financial support from the following laboratories: AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Chugaï, Janssen, MSD, Lilly, Pfizer, Roche, Sanofi, and Takeda.
Disclosure
D. Debieuvre: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Janssen, Sanofi-Winthrop, Amgen, Roche; Financial Interests, Personal, Invited Speaker: takeda; Financial Interests, Personal, Coordinating PI: Pfizer; Financial Interests, Institutional, Funding: Roche, AstraZeneca, Janssen, MSD, Pfizer, BMS, Lilly, Boehringer Ingelheim, GSK, Chugaï, Chiesi, Takeda, Bayer, Sanofi-Winthrop, Amgen, AbbVie. All other authors have declared no conflicts of interest.
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