Abstract 3996: Search for prognosis prediction factors in treatment selection for elderly patients with EGFR negative advanced stage non-small cell lung cancer patients

Abstract

Introduction: Since 40% of Japanese lung cancer patients are older than 75 years old, it is necessary to consider a specific strategy to treat such elderly lung cancer patients. From that aspect, it is very important to define frail or vulnerable elder populations who have lots of heterogenic health background in treatment of lung cancer. In this study, we have tried to identify prediction factors which significantly correlates to overall survival (OS) of such elderly advanced lung cancer patients by using of patient status and laboratory data before treatment. Objects and methods: Patients more than 75 years old who enrolled in this retrospective study were diagnosed as an advanced and EGFR negative non-small cell lung cancer during 2013-2017, and they were not available for any molecular targeted therapeutics. OS of best supportive care (BSC) cohort and chemotherapy with Docetaxel monotherapy and more cohort from those elderly patients were analyzed by Kaplan-Meier analysis. Results: Clinical Question 1; What is a prediction factor for OS of BSC patients? Answer 1; From analysis of 29 BSC patients (age 15-94 years old, median 82), it is revealed that low performance status (PS =0,1) stage at diagnosis (p=0.03) are significantly correlated to longer OS, and also hypoalbuminemia is significantly correlated to worse OS (11 wks vs 35 wks). Age at diagnosis did not correlate to duration of OS. ( more vs less than 80 years old:15 wks vs 37 wks, P=0.13)Clinical Question 2; Does chemotherapy significantly prolong OS of elderly patients? Answer 2; Kaplan-Meier analysis of elderly patients (PS 0-2) less than 80 years old who were treated by chemotherapies at least with DOC monotherapy showed longer OS than that of 29 BSC patients ( 84 wk vs 15 wk, p=0.006). However, no significant difference to OS (p=0.378) has been observed to BSC patients in advanced stage with better PS (0-2). Multivariate analysis for OS indicated significant correlation of hypoalbuminemia (p=0.002), but no correlation of chemotherapy (p=0.202) has been observed. Conclusion: 1, EGFR mutation-negative advanced NSCLC patients elder than 80 years old who were treated by chemotherapies did not showed significantly longer OS than that of BSC patients. 2, PS and hypoalbuminemia before treatment may be prediction factors for longer OS of elder lung cancer patients. Citation Format: Yoshiko Kaneko, Takako Mouri, Nobuyo Tamiya, Tadaaki Yamada, Junji Uchino, Koichi Takayama. Search for prognosis prediction factors in treatment selection for elderly patients with EGFR negative advanced stage non-small cell lung cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3996.