Abstract 95P
Background
This study aimed to describe neoadjuvant treatment patterns, rwEFS, OS and assess association between rwEFS and OS in resected eNSCLC.
Methods
This retrospective study used the US SEER-Medicare data (2007–2019) to select pts with newly diagnosed, resected, stage II-IIIB (N2) NSCLC (AJCC 8th edition) treated with neoadjuvant therapy. Index date was defined as neoadjuvant therapy initiation. rwEFS (time from index date to first recurrence or death, whichever first) and OS (time from index date to death) were described using Kaplan-Meier analysis and correlation was assessed using normal scores rank test. OS was compared between pts with and without recurrence by 1, 2, and 3-year landmarks after index date; hazard ratios were estimated using Cox models adjusted for key baseline factors.
Results
221 pts (156 with recurrence and 65 without) met eligibility criteria (median follow-up: 32.7 months). Selected pt characteristics are presented in the table. ∼97% received platinum-based neoadjuvant therapy and ∼49% received neoadjuvant chemoradiation. Carboplatin + paclitaxel, cisplatin + etoposide, and carboplatin + pemetrexed are most frequently used regimens. Median rwEFS was 17.6 months; median OS was 48.5 months. The normal scores rank correlation demonstrated a statistically significant correlation between rwEFS and OS (0.68; P < 0.001). Pts with recurrence by each landmark had significantly shorter OS than those without recurrence (All Ps <0.01). Adjusted Cox models indicated that pts with recurrence had 2.7–3.2 times increased risk of death (All Ps <0.05).
Table: 95PSelected characteristics, rwEFS and OS among patients with early-stage, resected NSCLC who have received neoadjuvant therapy
| Patient characteristics | |
|---|---|
| Age at surgery (years), mean ± SD | 72.1 ± 4.9 |
| Male, N (%) | 126 (57.0%) |
| White | 191 (86.4%) |
| Adjuvant chemotherapy, N (%) | 67 (30.3%) |
| Post-operative radiotherapy, N (%) | 56 (25.3%) |
| rwEFS rate | |
| 1-year | 61.1% |
| 2-year | 42.4% |
| 3-year | 33.3% |
| 4-year | 26.9% |
| 5-year | 20.9% |
| OS rate | |
| 1-year | 91.4% |
| 2-year | 72.4% |
| 3-year | 60.6% |
| 4-year | 50.3% |
| 5-year | 44.9% |
Abbreviations: NSCLC: non-small cell lung cancer; rwEFS: real-world event-free survival; OS: overall survival; SD: standard deviation.
Conclusions
Among pts with resected eNSCLC receiving neoadjuvant therapy, poor survival outcomes were observed. rwEFS is positively and significantly associated with OS. These findings highlight the need for and importance of more effective treatments for this pt population.
Legal entity responsible for the study
The authors.
Funding
Merck and Co. Inc.
Disclosure
J. Donington: Financial Interests, Personal, Invited Speaker: AstraZeneca, Merck and Co. Inc, Bristol-Myers Squibb, Roche/Genentech; Financial Interests, Personal, Advisory Board: AstraZeneca, Merck and Co. Inc, Bristol-Myers Squibb, Roche/Genentech.
X. Hu: Financial Interests, Personal, Full or part-time Employment: Merck and Co. Inc; Financial Interests, Personal, Stocks/Shares: Merck and Co. Inc.
S. Zhang: Financial Interests, Institutional, Other, Su Zhang is an employee of Analysis Group Inc., which received research funding from Merck and Co., Inc. to conduct this study: Merck and Co.
Y. Song: Financial Interests, Institutional, Other, Yan Song is an employee of Analysis Group Inc., which received research funding from Merck and Co., Inc. to conduct this study: Merck and Co. Inc.
C. Gao: Financial Interests, Institutional, Other, Chi Gao is an employee of Analysis Group Inc., which received research funding from Merck and Co., Inc. to conduct this study: Merck and Co. Inc.
A. Arunachalam: Financial Interests, Personal, Full or part-time Employment: Merck and Co. Inc; Financial Interests, Personal, Stocks/Shares: Merck and Co. Inc.
D. Chirovsky: Financial Interests, Personal, Full or part-time Employment: Merck and Co. Inc; Financial Interests, Personal, Stocks/Shares: Merck and Co. Inc.
A. Lerner: Financial Interests, Institutional, Other, Ari is an employee of Analysis Group Inc., which received research funding from Merck and Co., Inc. to conduct this study: Merck and Co. Inc.
A. Jiang: Financial Interests, Institutional, Other, Anya is an employee of Analysis Group Inc., which received research funding from Merck and Co., Inc. to conduct this study: Merck and Co. Inc.
J. Signorovitch: Financial Interests, Institutional, Other, James Signorovitch is an employee of Analysis Group Inc., which received research funding from Merck and Co., Inc. to conduct this study: Merck and Co. Inc.
A. Samkari: Financial Interests, Personal, Full or part-time Employment: Merck and Co. Inc; Financial Interests, Personal, Stocks/Shares: Merck and Co. Inc.