Smoking cessation counseling in advanced non-small cell lung cancer (aNSCLC).

Abstract

e20551 Background: Lung cancer is the leading cause of cancer mortality, with smoking the major risk factor1. Advances in treatment (tx) are lengthening survivorship increasing the importance in smoking cessation among diagnosed pts. Barriers to counseling include: time, skill, patient motivation, prognosis and short survival2. This study analyzed smoking status and cessation counseling in better prognosis aNSCLC patients (pts) defined as those who completed at least two lines of systemic therapy (2L). Methods: Using Inovalon’s MORE2 Registry®claims data for July 2013–2014, pts with aNSCLC identified by ICD-9 codes and treated with chemotherapy (chemo) or targeted therapy (TT; erlotinib, ceritinib, afatinib, or crizotinib) were selected. Pts >18 years of age and treated with 1L therapy within 6 months of diagnosis and who completed 2L were eligible. Pts with small cell lung cancer or secondary malignancies, or pts enrolled in a trial, were ineligible. Smoking history was assessed based on ICD-9 codes (305.1, 649.0, 989.84, V15.82), cessation drug use (bupropion, varenicline, nicotine gum or patches), counseling procedure codes (99406, 99407, G0436, S9453). Results: Of 5,319 pts, 2,198 completed 2L; of those 241 (11%) received 1L TT and 1,957 (89%) 1L chemo. 1L TT had a higher proportion of females (66% vs. 52%, p<0.0001) and a lower smoking rate (33% vs. 58%, p<0.0001) compared to chemo. Cessation rates (counseling or drug) were 9% for 1L TT and 13% for 1L chemo. Conclusions: RWE assessment of smoking incidence and cessation counseling is feasible. Despite methodological limitations one third pts on 1L TT had smoking documentation. Evidence of smoking cessation was present in 12% of pts irrespective of 1L tx choice. Our findings warrant increased focus on smoking cessation in aNSCLC. [Table: see text]