Patients with a history of more than one cancer diagnosis: An opportunity to expand eligibility criteria?

Abstract

e23019 Background: Patients with a history of more than one cancer diagnosis are increasingly common due to improved cure rates in early-stage cancers, and a demographic shift towards an increasing proportion of elderly patients with cancer due to longer life expectancy. Having a prior cancer diagnosis is a common exclusion criteria in clinical trials but represents a large untapped pool of patients that could increase enrollment in trials. We assessed if there are differences in the clinical characteristics, NGS testing rates and the rate of actionable genomic alterations in patients with NSCLC with a history of at least one other cancer diagnosis. Methods: We analyzed patients with a NSCLC diagnosis and an appointment scheduled between Oct 23, 2023 and Jan 14, 2024 at three US community oncology sites. All patients were enrolled in the Kaleido Registry and descriptive statistical analyses were performed on curated data. Results: 221 patients were identified (110 male/111 female). Median age was 72 (range 37-95). 157 (72%) patients had NSCLC as their only cancer diagnosis and 67 (28%) had a history of other malignancy with a median time interval since the last cancer diagnosis of 78 months (interquartile range 28-141 months ). 49 patients had a history of 1 other cancer diagnosis and 18 patients had a history of 2 or more. The most common diagnoses were breast (n = 16, 7%), colon (n = 7, 3.2%), prostate (n = 7, 3.2%) and bladder (n = 4, 1.8%) cancers. There were no differences in median age (73 yrs, range 57-91 vs (72 yrs, range 37-95), or sex distribution (30/34 vs 80/77) between patients with multiple diagnoses vs those with only NSCLC. There was not enough power to detect a difference in the rates of NGS testing rates or actionable genomic alterations (EGFR/ALK/ROS1/KRAS/RET/MET/NTRK/BRAF/HER2) in the cohorts (51% vs 64%, respectively). Conclusions: One in four NSCLC patients had a history of other cancer diagnosis. There were no significant differences in baseline characteristics or actionable genomic alterations. The median interval since the last cancer diagnosis was more than 6 years and less than a third had less than 3 years. These findings indicate that a significant number of patients with prior cancer diagnoses may be suitable candidates for clinical trials as their risk of recurrence of prior disease is likely low given long follow-up in this cohort.