Effectiveness of Endoluminal Photodynamic Therapy in Patients With Advanced Non-small Cell Lung Cancer

Abstract

SESSION TITLE: Lung Cancer III SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM PURPOSE: We sought to assess health service use, cost, and survival in advanced (Stage IIIa) non-small cell lung cancer (NSCLC) patients treated with an integrated photodynamic therapy (+PDT) algorithm, compared to +non-PDT ablation. METHODS: Retrospective cohort analysis using SEER-Medicare linked data. Patients diagnosed with advanced (Stage IIIa) NSCLC between 2000 and 2011were identified and retrospectively followed for one-year pre and up to five-year post diagnosis. We analyzed health service use and incremental cost over the follow-up period for PDT and non-PDT ablation treatment groups. Cox regression models were used to study the association between all-cause and lung cancer-specific survival and treatment. We employed GLM log-link model to analyze cost of care. Propensity score approach was used to minimize selection bias. RESULTS: Of the advanced Stage IIIa NSCLC cohort (n=31694), 24 received +PDT, and 188 received +non-PDT ablation. Mean age, marital status and race was comparable between +PDT and +non-PDT ablation groups. However, the +PDT group had higher proportion of patients with one or more comorbidity, compared to +non-PDT group (75% vs 52%; p=0.05). Un-adjusted five year survival days were highest for +PDT group (mean 881, SD 738), compared to +non-PDT ablation group (mean 630,SD 679). Patients receiving + PDT showed lower hazard of overall five year mortality (HR=0.69, CI=0.43, 1.12), as well as lung cancer-specific mortality (HR=0.62, CI=0.35, 1.09), compared to +non-PDT ablation group. Five year medical care cost was higher for +PDT group (β=0.8425, p=0.0010), compared to the +non-PDT ablation therapy group. CONCLUSIONS: In Stage IIIa NSCLC patients, adding PDT to treatment algorithm showed trend towards improving all-cause and lung cancer-specific survival. Variation on cost and health resource utilization was associated treatment type. Ongoing outcomes studies will further evaluate survival, cost and quality of life metrics. CLINICAL IMPLICATIONS: Addition of PDT to treatment algorithm is associated with improved all-cause and lung-cancer specific survival in Stage IIIa NSCLC patients, compared to addition of other non-PDT ablation. DISCLOSURE: Sumedha Chhatre: Other: Consulting Patrick Ross: Grant monies (from industry related sources): Grant Ravishankar Jayadevappa: University grant monies: Research Grant No Product/Research Disclosure Information