Abstract 1897P
Background
Timely management of patients (Pts) with confirmed or suspected LC is a critical requirement of cancer hospitals; however, limited data are available for the timespan between first symptoms to being taken in charge by healthcare practitioners. Our analysis aims at determining factors with potential impact on time before actual start of clinical care and detect possible areas of improvement.
Methods
We retrospectively assessed Pts submitted to clinical oncologists of an Italian Comprehensive Cancer Network due to symptoms suggestive for LC (hence excluding incidental findings of LC and Pts who had already received radical treatments before oncological evaluation). Time from first symptom onset to diagnostic biopsy and to treatment start were assessed for all Pts and clinically relevant sub-groups, compared through Mann-Whitney test.
Results
392 consecutive Pts were included, with the following characteristics: Median age: 71 years; Males/females: 232 / 160; ever smoker vs. never smoker: 324 vs. 53 (+15 unknown); type of first symptom: 227 respiratory vs. 165 non-respiratory; ECOG PS: 0: 142; 1: 165; 2: 62; 3: 13; 4: 1; unknown: 9; Stages: Non-metastatic (II-III): 93; metastatic: 293; unknown: 6. Globally, median time from first symptom to diagnostic biopsy was 56 days, while median time from first symptom to treatment start was 108 days. Table: 1897P
| Characteristic | Time from symptom onset to biopsy (days) | P value | Time from symptom onset to treatment start (days) | P value |
| Age ≥70 vs < 70 years | 65 vs 49 | 0.2381 | 105 vs 103 | 0.5749 |
| Male vs Female | 63 vs 51 | 0.4861 | 108 vs 90 | 0.0427 |
| Ever smoker vs never smoker | 53 vs 83 | 0.0647 | 104 vs 136 | 0.0748 |
| Preexistent cardio-respiratory comorbidities (yes vs no) | 50 vs 61 | 0.6823 | 106 vs 103 | 0.5674 |
| Symptom onset (respiratory vs non-respiratory) | 59 vs 55 | 0.5910 | 108 vs 95 | 0.1668 |
| Worsening of first symptom (yes vs no) | 84 vs 48 | ConclusionsLonger time to biopsy was associated with worsening of the first occurring symptom, supporting the rationale for promoting sensibilization of Pts and general practitioners for identifying possible cancer-related symptoms earlier and avoiding worsening before starting diagnostic procedures. Furthermore, non-metastatic LC is associated with longer time to biopsy, possibly due to more complex differential diagnosis and reduced perception of urgency. Data collection is ongoing, and Pts with incidental finding of LC, as well as Pts treated with upfront radical approaches will be included in subsequent analyses. Clinical trial identificationEditorial acknowledgementLegal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureG. Rossi: Financial Interests, Personal, Speaker’s Bureau: Roche, AstraZeneca, BMS. G. Barletta: Financial Interests, Personal, Full or part-time Employment: AstraZeneca, GSK; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca, MSD, Roche; Financial Interests, Personal, Training: Pierre Fabre. M. Tagliamento: Non-Financial Interests, Member, International Lung Cancer Foundation Fellow: IASLC; Non-Financial Interests, Member, Lung Cancer Group: EORTC; Other, Other, Travel and accommodation expenses: Eli Lilly. M. Lambertini: Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, Lilly, Novartis, Pfizer, Exact Sciences, MSD, Seagen, Gilead, Menarini, Pierre Fabre; Financial Interests, Personal, Invited Speaker: Takeda, Sandoz, Ipsen, Libbs, Knight, Daiichi Sankyo, Lilly, Pfizer, Novartis, Roche, AstraZeneca, Menarini, Gilead; Financial Interests, Personal, Other, Travel grant to attend ASCO 2022: Gilead; Financial Interests, Personal, Other, Travel grant to attend ASCO 2023 and ASCO 2024: Daiichi Sankyo; Financial Interests, Personal, Other, Travel grant to attend SABCS 2023: Roche; Financial Interests, Institutional, Coordinating PI, 2-year research grant paid to my Institution: Gilead; Non-Financial Interests, Leadership Role, Chair of the ESMO Young Oncologists Committee from 01/2023 to 12/2024: ESMO; Non-Financial Interests, Member of Board of Directors, Member of the national council of the Italian Association of Medical Oncology (AIOM): AIOM. L. Del Mastro: Financial Interests, Personal, Invited Speaker, Educational meeting: Novartis, Symposia, Andromeda E20, Vyvamed srl; Financial Interests, Personal, Invited Speaker, Lecture: Ipsen; Financial Interests, Personal, Advisory Board, Her2+ and TN breast cancer: Roche; Financial Interests, Personal, Writing Engagement, Consultancy for TNBC text: Roche; Financial Interests, Personal, Advisory Board, denosumab: Amgen; Financial Interests, Personal, Advisory Board, Early and metastatic BC: Eli Lilly; Financial Interests, Personal, Invited Speaker, CDK4-6 inhibitors: Eli Lilly; Financial Interests, Personal, Advisory Board, tucatinib: Seagen Int; Financial Interests, Personal, Advisory Board, Oncotype dx: Exact sciences, Havas life; Financial Interests, Personal, Advisory Board, Neratinib: Pierre Fabre; Financial Interests, Personal, Invited Speaker, Internal training: MSD; Financial Interests, Personal, Invited Speaker, Educational meetings: Accademia Nazionale Medicina; Financial Interests, Personal, Writing Engagement, Author for BC text: Pensiero Scientifico Editore; Financial Interests, Personal, Advisory Board, Breast cancer: Uvet; Financial Interests, Personal, Other, Author slide kits and interviews: Think2it; Financial Interests, Personal, Advisory Board, Palbociclib: Pfizer; Financial Interests, Personal, Invited Speaker, Breast cancer: Aristea, Meeting SrL; Financial Interests, Personal, Other, Author slide kits: Forum service; Financial Interests, Personal, Other, Author text about biosimilars: Edizioni Minerva Medica; Financial Interests, Personal, Other, consultant: Kardo srl; Financial Interests, Personal, Invited Speaker, Breast cancer meetings: Delphi international, Over srl; Financial Interests, Personal, Invited Speaker: Prex Srl, Editree; Financial Interests, Personal, Advisory Board: Uvet, Collage SpA, Daiichi Sankyo, AstraZeneca, Agendia, Gilead, GSK, Eisai, Stemline Menarini; Financial Interests, Personal, Other, Interview: Infomedica srl; Financial Interests, Personal, Other, Consultant: Sharing progress in cancer care - Switzerland; Financial Interests, Personal, Other, Consultancy: Eli lilly, Gilead; Financial Interests, Institutional, Funding, National coordinating PI: Roche; Financial Interests, Institutional, Funding, Local PI: AstraZeneca, Roche, Eli Lilly, Daiichi Sankyo, Novella Clinical, Novartis; Financial Interests, Institutional, Local PI: Gilead, Seagen; Financial Interests, Institutional, Research Grant: Pfizer; Non-Financial Interests, Institutional, Product Samples, Genomic Test: FoundationOne. C. Genova: Financial Interests, Personal, Advisory Board: AstraZeneca, Roche, Novartis, Sanofi, Taked; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca, Roche, BMS, MSD, Eli Lilly, Novartis, Sanofi, Takeda, Thermofisher. All other authors have declared no conflicts of interest. 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