Abstract 169P
Background
Evolving treatment (Tx) options for early-stage NSCLC warrants understanding the real-world Tx patterns and associated survival outcomes to help refine current practice and inform future strategies.
Methods
The THASSOS-INTL (NCT04808050) Türkiye cohort, an observational, retrospective study, abstracted data of adult patients (pts) with clinical stage (CS) IA-IIIB resectable NSCLC (Jan 2013-Dec 2017) until their disease progression, death (last medical record) or Dec 2020. Primary objectives included Tx patterns and 3-year survival rates.
Results
Of 119 pts (median [range] age 60 [22–80] yrs; 77.3% [92/119] males; 83.2% [89/107] current/former smokers) enrolled, 25.2% had CS I, 37.0% CS II and 37.8% CS III. Most pts had adenocarcinoma (70.0%, 70/100) in right lung (68.9%, 82/119) with pN0 in 54.6% (65/119). Of 22 (18.5%) pts tested 1 had EGFR mutation; 3/5 pts had PD-L1 expression >1%. Overall, 71.4% (85/119) pts underwent curative surgery, majorly lobectomy (70.6%, 60/85) with R0 resection (81.2%, 69/85); 15.1% (18/119) pts underwent only surgery. Neo-adjuvant therapy (NT) was recorded in 10.1% (12/119) pts (systemic therapy [ST]: 75%, 09; ST + radiotherapy [RT]: 25%, 03). Adjuvant therapy (AT) was recorded in 77.3% (92/119) pts (ST: 73.9%, 68; RT: 2.2%, 02; ST + RT: 23.9%, 22). Both NT and AT were recorded in only 4 pts. At 3 years, 83.2% were alive with mOS of 8.7 yrs (95% CI: 8.0-NE). Disease progression was reported in 32.8% (39/119) pts ─ intra-thoracic and regional lymph node (51.3%), distant (41.0%), CNS (2.6%), unknown (5.1%). Post-progression, 66.7% (26/39) pts received ST and 46.2% (18/39) received RT.
Table 169P| Tx Patterns and Survival | |||||||
| Tx pattern, n (%) | Overall N=119 | CS 1A (11, 9.2%) | CS IB (19, 16.0%) | CS IIA (30,25.2%) | CS 11B (14,11.8%) | CS 111A(30,25.2%) | CS 111B (15, 12.6%) |
| Sx only | 18 (15.1) | 7 (63.6) | 7 (36.8) | 3 (10.0) | 0 | 0 | 1 (6.7) |
| NT + Sx | 12 (10.1) | 0 | 0 | 2 (6.7) | 2 (14.3) | 5 (16.7) | 3 (20.0) |
| Sx + AT | 92 (77.3) | 4 (36.4) | 12 (63.2) | 26 (86.7) | 13 (92.9) | 26 (86.7) | 11 (73.3) |
| NT + Sx + AT | 4 (3.4) | 0 | 0 | 1 (3.3) | 1 (7.1) | 2 (6.7) | 0 |
| Survival (95% CI) | |||||||
| 3-yr survival rate (%) | 83.2 (76.6–90.4) | 100 (100.0–100.0) | 88.5 (74.8–100.0) | 88.9 (77.8–100.0) | 85 7 (69 2–100 0) | 78.1 (64.0–95.3) | 60.0 (39.7–90.7) |
| mOS (yrs) | 8.7 (8.0-NE) | NE | 8.0 (7.8-NE) | NE | 8.7 (7.1-NE) | 9.0 (5.1-NE) | NE |
Conclusions
About 3/4th of pts receiving AT in the Türkiye cohort and a mOS of 8.7 yrs demonstrates adherence to the Tx recommendations. However, the 3-yr survival rates varied from 100% for CS IA to 60% for CS IIIB, emphasizing the need for optimized Tx sequencing and novel approaches. The poor biomarker testing rates underscore upfront testing at NSCLC diagnosis.
Clinical trial identification
NCT04808050.
Editorial acknowledgement
Medical writing support was provided by Dr. Purva Thatai and Prajakta Nachane of Fortrea Scientific Pvt Ltd.
Legal entity responsible for the study
AstraZeneca International.
Funding
AstraZeneca International.
Disclosure
S. Sezgin Goksu: Other, Institutional, Invited Speaker: Novartis, Pfizer, MSD, AstraZeneca; Other, Institutional, Advisory Role: Novartis, MSD. Y. Kilic: Financial Interests, Institutional, Full or part-time Employment: AstraZeneca. All other authors have declared no conflicts of interest.