Overall survival analysis and characterization of an EGFR mutated non small cell lung cancer (NSCLC) population

Aguiar, Filipa; Fernandes, Gabriela; Cirnes, Luı́s; Machado, José Carlos; Queiroga, Henrique; Moura, Conceição Souto; Hespanhol, Venceslau

doi:10.1183/1393003.congress-2017.pa4261

Cited by 5 publications

(8 citation statements)

References 9 publications

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“…Of the patients at IPO-Porto with NSQ who were tested for EGFR or ALK mutations/rearrangements, 20.1 and 8.8%, respectively, were found to have mutations/rearrangements. These rates are comparable to those reported in several observational studies conducted in Portugal and elsewhere in Europe in which rates ranged from 10 to 28% for EGFR mutations [15][16][17][18][23][24][25][26][27], and from 3 to 12% for ALK rearrangements [17,24].…”

Section: Discussionsupporting

confidence: 87%

“…The current study, constituting one of the largest real-world analyses of lung cancer patients in Portugal, serves to provide a comprehensive pre-immunotherapy 'baseline' picture for treatment patterns and outcomes for patients with advanced NSCLC in a major oncology referral centre in Portugal. Characteristics of the population of patients diagnosed with advanced NSCLC at IPO-Porto between 2012 and 2016 appeared to be broadly consistent with advanced NSCLC populations in other observational studies conducted in Portugal, Spain, and elsewhere in Europe around the same time frame [15][16][17][18][19]. Moreover, in alignment with other real-world cohorts, including those from central Europe, Belgium, Denmark, Spain, and Sweden [18][19][20][21][22], more than half of all patients diagnosed with NSCLC at IPO-Porto already had metastatic disease.…”

Section: Discussionsupporting

confidence: 73%

“…The presence of EGFR or ALK mutations/rearrangements was also significantly associated with a reduced risk of death in the IPO-Porto patient population. Other observational studies conducted in Portugal have also reported improved survival outcomes in patients with EGFR or ALK mutations/rearrangements versus in patients with a wildtype phenotype [15,16]. Approximately three-quarters (76%) of patients diagnosed with stage IIIB-IV NSCLC at IPO-Porto received at least one LoT after diagnosis.…”

Section: Discussionmentioning

confidence: 90%

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Real-world treatment patterns and survival outcomes for advanced non-small cell lung cancer in the pre-immunotherapy era in Portugal: a retrospective analysis from the I-O Optimise initiative

et al. 2020

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Background As part of the multinational I-O Optimise research initiative, this retrospective cohort study of patients with advanced non-small cell lung cancer (NSCLC) evaluated real-world treatment patterns and survival prior to immunotherapy reimbursement in Portugal. Methods This study utilized a database held by IPO-Porto, Portugal’s largest oncology hospital. Adult patients diagnosed with stage IIIB or IV NSCLC from January 2012 to December 2016 at IPO-Porto, with follow-up to June 2017, were included. Treatment analyses were performed from 2015 onwards. Kaplan–Meier methods were used for overall survival (OS). Factors associated with OS and systemic anti-cancer therapy (SACT) treatment were assessed using multivariate statistical models. Results Of 1524 patients diagnosed with NSCLC at IPO-Porto, 1008 patients had advanced disease (stage IIIB: 10.1%, 154/1524, stage IV: 56.0%, 854/1524). For those with advanced disease, median age was 65 years (range: 21–92) and 75.6% (762/1008) were male. Median OS (interquartile range [IQR]) was 11.4 (5.2–26.9) months for stage IIIB and 6.3 (2.4–15.0) months for stage IV. Factors associated with decreased risk of death included female sex and epidermal growth factor receptor gene (EGFR)/anaplastic lymphoma kinase gene (ALK) mutations/rearrangements; factors associated with increased risk of death included older age and stage IV disease. Among patients diagnosed in 2015 or 2016, 75.8% (297/392) received ≥1 line of SACT. Platinum-based chemotherapy was the most common first-line therapy (non-squamous cell carcinoma [NSQ]: 72.9%; squamous cell carcinoma [SQ] 87.3%, 55/63; patients with EGFR/ALK mutations/rearrangements primarily received tyrosine kinase inhibitors). The likelihood of receiving SACT was lower in older patients and those diagnosed with stage IV disease. Patients not receiving SACT had poor survival outcomes (median OS [IQR]: NSQ, 1.8 [1.1–3.1] months; SQ, 2.3 (1.3–3.4) months), while median OS (IQR) in SACT-treated patients was 12.6 (6.1–24.5) months for NSQ and 10.3 (5.7–15.9) months for SQ. Conclusions This real-world data analysis from a large Portuguese oncology hospital demonstrates a high disease burden for advanced NSCLC in the pre-immunotherapy era, with nearly one-quarter of patients not receiving SACT. Even in patients receiving SACT, median survival was only about 1 year.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 90%

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Real-world treatment patterns and survival outcomes for advanced non-small cell lung cancer in the pre-immunotherapy era in Portugal: a retrospective analysis from the I-O Optimise initiative

et al. 2020

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“…The improved overall survival among overseas‐born patients may be due to the greater proportion of non‐smokers compared with Australian‐born patients in our study. There is a greater prevalence of Epidermal Growth Factor Receptor (EGFR) mutations in non‐smokers, which have been associated with better overall survival compared to non‐mutated cancers …”

Section: Discussionmentioning

confidence: 99%

Radiotherapy patterns of care for stage I and II non‐small cell lung cancer in Sydney, Australia

Nguyen

Wong²,

Beydoun

et al. 2018

J Med Imag Rad Onc

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Introduction: Curative radiotherapy is guideline treatment for inoperable patients of good performance status with Stage I & II Non-Small Cell Lung Cancer (NSCLC). The aim of this study was to evaluate radiotherapy patterns of care in these patients, the reasons for palliative treatment and the proportion of patients suitable for curative stereotactic ablative body radiotherapy (SABR). Methods: Electronic oncology databases at three institutions were queried to retrieve data on patients with inoperable Stage I & II NSCLC seen in radiation oncology clinics between 1/1/2008 and 31/12/2014. Suitability for SABR was defined as peripheral tumours less than 5 cm in size. Factors associated with curative treatment were determined using univariate and multivariate analyses. Results: Three-hundred-and-twelve patients were identified of whom 178 (57%) received curative radiotherapy, 58 (19%) palliative radiotherapy and 76 (24%) no radiotherapy. The main reason for receiving palliative rather than curative treatment was COPD or poor pulmonary function (26%). Method of diagnosis (P = 0.031), Simplified Comorbidity Score (P = 0.003), ECOG performance status (P = 0.016), FEV1% (P = 0.040), treating institution (P < 0.0001) and time period (P = 0.016) were associated with curative radiotherapy on multivariate analysis. In patients with T1-2N0M0 NSCLC, 19 (31%) who did not receive treatment and 7 (21%) who underwent palliative radiotherapy were technically and clinically suitable for SABR. Conclusion: Only 57% of patients with Stage I-II NSCLC were treated with curative radiotherapy. Patient factors were the predominant reason for palliative treatment, however, treating institution also played a role. A considerable proportion of patients who underwent palliative or no radiotherapy were suitable for SABR treatment.

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“…Besides, it would be possible to speculate that immunotherapy may even have a beneficial effect in COPD alone with no lung cancer. Certainly, more studies are needed to better define the implications of cellular immunology and immune checkpoints in the potential links between COPD and lung cancer in patients as shown to occur with other biomarkers in patients (18)(19)(20). Elucidation of the most relevant molecular mechanisms will pave the way to predict the response to immunotherapy in patients with lung cancer with and without COPD.…”

mentioning

confidence: 99%

Immune phenotypes in lung cancer patients with COPD: potential implications for immunotherapy

2018

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Overall survival analysis and characterization of an EGFR mutated non small cell lung cancer (NSCLC) population

Cited by 5 publications

References 9 publications

Real-world treatment patterns and survival outcomes for advanced non-small cell lung cancer in the pre-immunotherapy era in Portugal: a retrospective analysis from the I-O Optimise initiative

Real-world treatment patterns and survival outcomes for advanced non-small cell lung cancer in the pre-immunotherapy era in Portugal: a retrospective analysis from the I-O Optimise initiative

Radiotherapy patterns of care for stage I and II non‐small cell lung cancer in Sydney, Australia

Immune phenotypes in lung cancer patients with COPD: potential implications for immunotherapy

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