1306P - Initial Report of Cohort Study in Patients with Non-Small-Cell Lung Cancer (NSCLC) who were Treated with 1st-Line Platinum-Based Chemotherapy (Sapphire Study)

Abstract

ABSTRACT Background Although 2nd-line chemotherapy comprises the standard of care for NSCLC, not every patient could receive one. How many and why did they miss the opportunity are not fully investigated. Methods We prospectively registered consecutive patients with NSCLC treated with platinum-based 1st-line therapy from April 2010 to September 2011 from 30 institutions in Japan. Baseline characteristics, regimens and responses for the 1st-line therapy, whether the patients received 2nd-line chemotherapy or not, and if not treated, the reason was recorded. This study was supported by the Public Health Research Center Foundation CSPOR. Results A total of 866 patients were registered. Patient characteristics were: median age, 65 (24 - 80); female patients, 27.5%; ECOG PS 0 or 1, 91.6%; adenocarcinoma, 69.6%; squamous cell carcinoma, 20.1%; never smoker, 20.1%; EGFR activating mutation positive, 10.2%. Maintenance chemotherapy was administered to 28.9% (131 / 454) of patients whose disease did not progress during the course of 1st-line chemotherapy. Among 592 patients with at least 6 months of follow-up, 193 were excluded (129 PD during the course of 1st-line chemotherapy, 20 ongoing 1st-line chemotherapy, and 44 others). The remaining 399 patients were analyzed with regard to administration of 2nd-line chemotherapy. A total of 135 patients (33.8%) did not receive 2nd-line chemotherapy, and the reasons were: without disease progression, 42 (31.1%); declined PS, 55 (40.7%); patient refusal, 20 (14.8%); death of any cause, 5 (3.7%). Therefore, approximately 20% of patients missed their opportunity to receive appropriate 2nd-line chemotherapy during follow-up period after completion of effective 1st-line therapy. Conclusion This is the largest prospective observational study exploring the proportion and the reasons for NSCLC patients not receiving 2nd-line chemotherapies. Further investigations to identify predictive factors for ‘missing the opportunity for 2nd-line chemotherapy’ are underway. Disclosure All authors have declared no conflicts of interest.