PUB022 A Cross-Sectional Study of Diagnostic Examinations and First-Line Treatment Patterns of Lung Cancer in Jiangsu Provence, China

Abstract

Jiangsu Provence was among the top in economic and cultural development in China, and so did the prevalence of lung cancer. The objective of this study was to explore the usually used auxiliary examinations in diagnosis of lung cancer, first-line anti-cancer regimens, as well as gene aberration test status of patients with lung cancer in Jiangsu Provence, China. 22 tertiary hospitals in Jiangsu Provence were involved in this study. Patients who were diagnosed with Lung cancer between March and May in 2016 and had never been treated before were enrolled. Patients information including demographics, histological subtypes, stages, family history of lung cancer, clinical manifestations, auxiliary examinations, gene aberration test status and first-line anti-cancer regimens were collected 1-2 days after patients discharging from hospitals. Descriptive statistics about diagnostic examinations, gene aberration test conditions, and first-line treatment patterns were performed. A total of 928 patients from 22 comprehensive and specialist hospitals in Jiangsu Provence were enrolled. Chest computerized tomography (CT) was the most commonly used auxiliary examination (95.7%) for screening of high-risk populations of lung cancer. If pathology needed, TBLB and TTNA were often performed. For SCLC, only patients staged T1-2N0M0 tend to select surgery, the other mostly cisplatin and etoposide chemotherapy. For NSCLC with stage I and II, surgery was the preferred option while for stage III and IV, chemotherapy dominated the first-line regimen, which mainly referred to cisplatin and pemetrexed regimen. As for gene aberration test, detection rate of EGFR gene mutation was 28.0% in non-selective NSCLC, 33.2% for locally advanced or metastatic NSCLC, and 39.3% for advanced non-squamous NSCLC, and the positive rate was 49.3%, 53.8% and 54.5%, respectively. The frequency of ALK gene fusion, c-MET gene amplification, ROS1 gene fusion and RET gene rearrangement were 4/111, 3/11, 5/26 and 0/3 respectively. 72.7% of patients with EGFR mutation were treated with TKIs, while it was only 5.5% for patients with EGFR mutation negative or unknown. In Jiangsu Provence, chest CT scanning was the most commonly used screening method for diagnosis of lung cancer. First-line treatment patterns were basically in accordance with stage and EGFR mutation status, although some disparities unavoidable.