P3.15-27 Initial Response to First Line Treatment is the Best Predictor of the Patient Survival in Advanced NSCLC

Abstract

Although most of the NSCLC patients are treated according to the standart guidelines, the patients who present in routine clinical practice usually have inferior performance status, in comparison to the patients registered in the clinical trials. Also in comparison, the frequency and thoroughness of the tests and procedures the clinical trial patients subjected are more intense as well. The oncologist practising in community needs simpler ways and means to assess patients' disease course to make timely and reliable judgement on their management. We searched among 5130 patients treated in our clinic since 2006 to find 678 lung cancer patients of all stages and pathology. Of these, 171 advanced stage NSCLC patients that were treated primarily under our supervision are selected for the calculations. The other histologies and the patients seen once or twice for a second opinion are excluded. The common patients characteristics including age, gender, stage, date of diagnosis, the date of progression, the site and the number of metastasis etc. are all recorded. The median age of the patients were 62, 23% were female, the median overall survival was 18 months. The majority did not receive any targeted immunotherapy because either it did not exist back then or they had access problems in more recent times. We did then univariate/moltivariate analysis of survival according to the age, gender, site of metastasis, platin vs non-platin based treatment and response to first line of chemotherapy. Of these, only the response to first line of therapy appeared as a statitically significant variable, 23 vs 14 months with p=0.0001. In over 90% of the patients, the radiological findings were in line with clinical picture. Although more complex and costly measures exist to predict the overall survival of the NSCLC patients, in our experience the clinical responsiveness to first line of chemotherapy most precisely predicted the overall survival. This simple measure may help the healthcare profesionals to understand the disease course of the patients and manage their needs in more proper fashion.