Found 1 Presentation For Request "1558P"
1558P - Biomarker status as a mediator of age-related overall survival (OS) in advanced non-small cell lung cancer (aNSCLC) (ID 1132)
- Aaron B. Cohen (New York City, United States of America)
Abstract
Background
Risk models for NSCLC have identified age as a prognostic factor, but the relevance of molecular biomarkers to age-related outcomes is undefined. We explored the prevalence of biomarkers by age group and the impact of biomarker status on age-related differences in OS among aNSCLC patients (pts) in a real-world population.
Methods
Pts with stage IIIB, IV or recurrent metastatic NSCLC (diagnosed 1/1/11 to 11/30/18) were identified in a US-based, EHR-derived, deidentified database (Flatiron Health). Cox proportional hazard regressions evaluated OS by age at aNSCLC diagnosis (dx) (< vs ≥ 50 years), controlling for gender, histology, race, stage, dx year, smoking status, visit site, region and PDL1 status. Sequential and subgroup regressions modeled ALK+, EGFR+ and ROS1+ biomarker status as mediators of the age effect on OS.
Results
Our sample included 41,024 pts (median age 69 years); median OS was 11 months. Pts <50 years lived longer than pts ≥50 years (HR: 0.83; p < 0.001). Molecular testing and positive results for ALK, EGFR and ROS1 were higher in age <50 (Table); this finding was maintained for non-squamous pts (p ≤ 0.001). Within ALK+, EGFR+ or ROS1+ subgroups, age was not associated with OS. Sequential variable analysis found 35% of the association between age and OS may be explained by ALK, EGFR and ROS1 biomarker status. 1558P Baseline characteristics by age at aNSCLC Dx* All age comparisons p < 0.001; among testedAll, n (%) N = 41,024 < 50 y, n (%) n = 1381 ≥50 y, n (%) n = 39,643 Female 19,301 (47) 716 (52) 18,585 (47) Non-squamous histology 28,203 (69) 1092 (79) 27,111 (68) Non-smoker 4723 (12) 323 (23) 4400 (11) ALK tested 23,618 (58) 948 (69) 22,670 (57) ALK+ 625 (2.6) 106 (11) 519 (2.3) EGFR tested 25,276 (62) 1000 (72) 24,276 (61) EGFR+ 3009 (12) 162 (16) 2847 (12) ROS1 tested 12,310 (30) 514 (37) 11,796 (30) ROS1+ 113 (0.92) 12 (2.3) 101 (0.86)
Conclusions
Young aNSCLC pts have longer OS than older pts; this benefit is significantly mediated through biomarker status. Pts with mutations had similar OS regardless of age group. As older pts are tested less often and have a lower prevalence of mutations, future work should explore whether increased testing in older pts may mitigate the age-related OS disparity.
Legal entity responsible for the study
Flatiron Health.
Funding
Flatiron Health.
Disclosure
A.B. Cohen: Shareholder / Stockholder / Stock options, Full / Part-time employment: Flatiron Health, an independent subsidiary of Roche; Shareholder / Stockholder / Stock options: Roche. B.D.A.P. Neri: Shareholder / Stockholder / Stock options, Full / Part-time employment: Flatiron Health, an independent subsidiary of the Roche group. B.J.S. Adamson: Full / Part-time employment, Provisional patent filed: Flatiron Health, an independent subsidiary of Roche; Non-remunerated activity/ies, Provisional patent filed: University of Washington; Research grant / Funding (self): American Foundation for Pharmaceutical Education; Research grant / Funding (institution): PhRMA Foundation; Leadership role: International Society for Pharmacoeconomics and Outcomes Research; Advisory / Consultancy: Salutis Consulting; Advisory / Consultancy: Fred Hutchinson Cancer Research Center; Advisory / Consultancy: Institute for Disease Modeling, Intellectual Ventures; Advisory / Consultancy: Boston Scientific; Shareholder / Stockholder / Stock options: Roche. C.M. Scanlon: Shareholder / Stockholder / Stock options, Full / Part-time employment: Flatiron Health, an independent subsidiary of Roche. C. Gross: Honoraria (self), Travel / Accommodation / Expenses: Flatiron Health, Inc., which is an independent subsidiary of the Roche Group; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): Johnson & Johnson. N.J. Meropol: Shareholder / Stockholder / Stock options, Full / Part-time employment: Flatiron Health, Inc., which is an independent subsidiary of the Roche Group; Shareholder / Stockholder / Stock options: Roche. R.A. Miksad: Shareholder / Stockholder / Stock options, Full / Part-time employment: Flatiron Health, Inc., which is an independent subsidiary of the Roche Group; Shareholder / Stockholder / Stock options: Roche; Advisory / Consultancy: De Luca Foundation.