Abstract 1457P
Background
Real-world data is lacking on survival in advanced gastro-oesophageal (aGO) cancer patients treated with best supportive care (BSC) only. This knowledge is vital to personalise cancer treatment and obtain truly informed consent. This study aimed to define and compare survival in aGO cancer patients treated with and without palliative chemotherapy (CTx), and to explore the factors that impact prognosis.
Methods
Patients in NHS Tayside, Scotland, diagnosed with aGO adenocarcinoma (defined as non-resectable) between 01/01/2016-31/12/2017 were identified retrospectively. Clinical data was obtained from electronic records. For both groups, survival was defined as date of diagnosis to date of death. Patients in the BSC group either chose not to have CTx or were deemed not suitable. Kaplan-Meier analysis for survival was performed to determine median overall survival (mOS) and Cox Regression analysis used to determine contributing factors. Local ethical approval was obtained.
Results
116 eligible patients were identified. There was a significant difference in mOS between patients in the BSC and CTx groups (93 days(d) vs 274 days, p<0.001). This was maintained when those deemed not fit for CTx were removed. One-year survival was 18.7% v 34.1% (p=0.063). Cox regression analysis in the BSC group identified stage (p<0.001) and performance status (PS) (p=0.021) as having independent predictive value for survival. Age was not related to outcome. Those with palliative stents, n= 31, had a mOS 137d v 56d for those who did not, n=44 (p=0.219). Table: 1457P
| BSC (n=75) | CTx (n=41) | P-value | |
| Age (SD) | 80 (9.03) | 66 (10.94) | <0.0001 |
| Gender; M:F (%) | 64%:36% | 78%:22% | 0.118 |
| Stage 4 (%) | 42.7% | 70.7% | 0.015 |
| PS 0-2 (%) | 72% | 97.6% | <0.0001 |
| mOS (95% CI) days | 93 (60-126) | 274 (221-327) | <0.0001 |
| mOS PS 0-2 (95% CI) days | 115 (53-177) | 274 (222-326) | <0.0001 |
| 1-year OS (%) | 18.7% | 34.1% | 0.063 |
Conclusions
To our knowledge, this is the largest reported study in Europe of outcomes in GO cancer patients treated with BSC only. The mOS with BSC is approximately 3 months. Cancer stage and ECOG PS has a role in prognostication in this setting. Our findings support the benefit of palliative chemotherapy in this population and real-world survival corresponds to published trial data.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Professor Russell Petty.
Funding
Has not received any funding.
Disclosure
R. Petty: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Lilly; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Pfizer Pharmaceuticals Israel; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Sanofi; Honoraria (self), Advisory/Consultancy: Servier Laboratories Ltd; Research grant/Funding (self), Travel/Accommodation/Expenses: AstraZeneca; Research grant/Funding (self): Boston Biomedical; Research grant/Funding (self): Clovis Oncology; Research grant/Funding (self), Travel/Accommodation/Expenses: Five Prime Therapeutics; Research grant/Funding (self): Janssen; Research grant/Funding (self): Merck Serono; Research grant/Funding (self): MSD Brazil; Research grant/Funding (self): Roche. All other authors have declared no conflicts of interest.