Abstract 186P
Background
Immunotherapy has revolutionized the treatment of metastatic non-small cell lung cancer (NSCLC). However, there are still few studies that analyze the impact of poverty and depopulation on the survival of these patients.
Methods
This single-center, ambispective study included patients diagnosed without first-line druggable mutation-free metastatic NSCLC diagnosed between 2018 and 2023. Patients who received first-line treatment with immunotherapy (anti PD-1) alone or in combination with chemotherapy were included. In the primary outcome the study evaluated OS and PFS according to socioeconomic status and according to the location of their home (rural vs. urban). Secondary outcome, OS and PFS were evaluated according to performance status at diagnosis assessed by the ECOG scale and age at diagnosis.
Results
189 patients were included. In high and medium high socioeconomic class patients. OS was 26 months (m) vs 13 m in low and medium low socioeconomic class (p Log Rank 0.060; p Breslow 0.047). PFS was 13 vs 11 m (p Log Rank 0.795). In patients living in an urban environment OS was 30 m vs 18 m in those living in a rural environment (p Log Rank 0.055; p Breslow 0.044). PFS was 13 vs 11 m (p Log Rank 0.496). Based on ECOG at diagnosis, OS was 39 m, 15 m and 7 m in those patients with an ECOG 0, 1 and 2, respectively (p Log Rank 0.001; p Breslow 0.001). PFS was 18 m, 9 m and 5 m respectively (p Log Rank 0.001; p Breslow 0.001). In patients younger than 70 years OS was 21 m vs 17 m in those older than 70 (p Log Rank 0.101; p Breslow 0.053). In high PD-L1 expressors older than 70 years OS was 12 m vs 46 m in high expressors younger than 70. In low PD-L1 expressors younger than 70 OS was 22 m vs 20 m in low expressors older than 70 (p Log Rank 0.112; p Breslow 0.087).
Conclusions
We observed that those patients living in rural areas have lower OS than those residing in urban areas. Patients with low incomes have worse survival than those with high incomes. Depopulation, long distance to the reference hospital and poverty may be important prognostic factors for patients with NSCLC. Medical oncologists should urge health authorities to adopt health and social policies that help to analyze the socioeconomic situation of patients at diagnosis and protect those most vulnerable.
Legal entity responsible for the study
University Hospital of Salamanca.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.