Abstract 1384P
Background
Lung cancer is the leading cause of cancer death, accounting for about one-fifth of all cancer deaths. Lung cancer is broadly split into non-small cell lung cancer (NSCLC) (about 80%-85% of cases) and small cell lung cancer (SCLC). Survival is affected by different disease factors, most of which are described in clinical trials. Our objective was to identify poor prognostic factors for survival in patients with stage IV lung adenocarcinoma in real clinical practice.
Methods
We used the SEER database, selecting all patients with stage IV lung adenocarcinoma diagnosed between 2010-15, to describe median overall survival (mOS). Chi-squared bivariate analysis was used for the association of binary qualitative variables, and the ANOVA test was used to compare two or more variables. A multivariate Cox regression analysis was performed to determine the impact of these prognostic factors on OS.
Results
A total of 46,030 patients were included: 51.3% men, 54.8% ≥65 years old (mean 67.03); 68.5% Caucasian; 44.7% lived alone. At diagnosis, metastases were found in bone (39.8%), brain (27.8%), liver (16.4%), and lung (30.3%). In total, 46.51% of patients had only one metastatic site, 29.76% had ≥2, and 21.9% had more metastatic sites. In the overall population, mOS was 6 (95%CI: 5.90–6.09) months (men: 5 mo; women: 7 mo, p < 0.001). Among patients with only one site of metastasis, liver metastases had the worst mOS (5 mo; 95%CI: 4.47–5.52), followed by bone metastases (7 mo, 95%CI: 6.73–7.27), brain metastases (7 mo, 95%CI: 6.70–7.30), and lung metastases (9 mo; 95%CI: 8.55–9.44). Patients with two or more sites of metastases showed the worst mOS (≤4 mo) only if liver metastases were present. Among patients with liver metastases, 78.3% had at least one other involved site (bone: 76.4%; Lung: 47.1%; and brain: 37.2%). Multivariate analysis showed that OS was mostly affected by liver metastases (HR=1.447, p < 0.001), age ≥65 years (HR=1.366, p < 0.001), and bone metastases (HR=1.207, p < 0.001).
Conclusions
Liver metastases were identified as the worst prognostic factor in patients with metastatic lung adenocarcinoma. Thus, their presence should be taken into account in future studies evaluating new cancer treatments, such as immunotherapy.
Clinical trial identification
Editorial acknowledgement
The authors thank Blanca Piedrafita, Ph. D. and Alfonsina Trento, Ph.D., medical writers at Medical Statistics Consulting S.L. (Valencia, Spain), for their collaboration in the edition of this abstract.
Legal entity responsible for the study
Roche Farma.
Funding
Roche Farma.
Disclosure
B. Campos Balea: Advisory/Consultancy: Boehringer; Travel/Accommodation/Expenses: Boehringer Ingelheim; Advisory/Consultancy: Sanofi; Speaker Bureau/Expert testimony: Roche; Travel/Accommodation/Expenses: Roche; Speaker Bureau/Expert testimony: Merck; Speaker Bureau/Expert testimony: BMS; Speaker Bureau/Expert testimony: AstraZeneca; Travel/Accommodation/Expenses: Lilly. J. de Castro Carpeño: Advisory/Consultancy: Roche; Speaker Bureau/Expert testimony: Roche; Travel/Accommodation/Expenses: Roche; Advisory/Consultancy: Merck; Advisory/Consultancy: Merck; Travel/Accommodation/Expenses: Merck; Advisory/Consultancy: BMS; Travel/Accommodation/Expenses: BMS; Advisory/Consultancy: AstraZeneca; Speaker Bureau/Expert testimony: AstraZeneca; Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy: Pfizer; Advisory/Consultancy: PharmaMar; Advisory/Consultancy: Boehringer Ingelheim; Speaker Bureau/Expert testimony: Boehringer Ingelheim; Advisory/Consultancy, Speaker Bureau/Expert testimony: Takeda; Advisory/Consultancy: Tesaro. B. Massuti: Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy, Speaker Bureau/Expert testimony: Boehringer Ingelheim; Advisory/Consultancy: Takeda; Speaker Bureau/Expert testimony: BMS; Speaker Bureau/Expert testimony: Pfizer. D. Vicente-Baz: Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy, Speaker Bureau/Expert testimony: BMS; Advisory/Consultancy, Speaker Bureau/Expert testimony: AstraZeneca; Advisory/Consultancy, Speaker Bureau/Expert testimony: Pfizer; Advisory/Consultancy, Speaker Bureau/Expert testimony: Boehringer; Advisory/Consultancy: Takeda. D. Pérez Parente, P. Ruiz Gracia: Full/Part-time employment: Roche. M. Cobo Dols: Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony: BMS; Advisory/Consultancy, Speaker Bureau/Expert testimony: AstraZeneca; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Boehringer Ingelheim.