81P Predictive molecular parameters of pneumonitis development in stage IIIa NSCLC patients treated with neo-adjuvant chemo-immunotherapy from NADIM clinical trial

e17506 Background: The optimal management of stage IIIA NSCLC has not been clearly defined. Much of this controversy is due to the heterogenity of this group. The current standard for unresectable stage IIIA disease is concurrent chemoradiotherapy. In patients with resectable stage IIIA disease however, neoadjuvant treatment followed by surgery provides better outcomes but not a significant survival benefit. Our study analyzed the management of stage IIIA NSCLC patients diagnosed at Kettering Health Network (KHN) and the observed 5-year survival as compared to the current NCCN guidelines and national 5-year relative and observed survival using the SEER database and National Cancer Database statistics. Methods: This retrospective study included all patients treated at KHN for Stage IIIA NSCLC from January 2004 to December 2009. 117 cases were analyzed, 53% female and 47% male. 42% were squamous cell, 28% adenocarcinoma, and the final 30% accounting for the remaining histology. 20 patients were not candidates for therapy due to poor performance status or comorbidity. 37 of the 97 patients under active treatment underwent resection at some point during treatment and 60 patients were deemed unresectable. Results: 68% of individuals with unresectable NSCLC received definitive concurrent chemoradiation, 32% received chemotherapy alone. In regards to resectable stage IIIA, 25% were treated with neoadjuvant therapy. 54% received postoperative therapy. 21% were treated with surgery alone due to multiple factors. The observed 5-year survival was 12.2% as compared to 10% nationally. The SEER data 5-year relative survival from 2001 to 2007 for stage IIIA NSCLC is 14%. Conclusions: In this heterogenous group of patients, treatment provided at KHN was individualized and followed national trends. The majority of unresectable stage IIIA NSCLC patients at KHN received the standard approach of concurrent chemoradiation. In terms of resectable stage IIIA NSCLC, approximately 25% were treated with either neoadjuvant chemotherapy or chemoradiotherapy. Overall, the 5-year survival rate for stage IIIA NSCLC at KHN is comparable to other community hospitals however slightly lower than the national average.

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Correction to: Trimodally treatment for stage IIIa NSCLC patients increases survival while not effecting surgical mortality or complexity

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-0856-4 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Dan Aravot ◽

Yaron D. Barac ◽

Efrat Krutzwald-Josefson ◽

Aaron M. Allen ◽

Dov Flex ◽

...

Keyword(s):

Surgical Mortality ◽

Stage Iiia ◽

Iiia Nsclc ◽

Nsclc Patients

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P60.07 TMB and Selected Mutations in Resectable Stage IIIA NSCLC Patients Receiving Neo-Adjuvant Chemo-Immunotherapy from NADIM Trial

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.01.966 ◽

2021 ◽

Vol 16 (3) ◽

pp. S543

Author(s):

A. Cruz-Bermudez ◽

M. Casarrubios ◽

R. Laza Briviesca ◽

E. Nadal ◽

A. Insa ◽

...

Keyword(s):

Stage Iiia ◽

Iiia Nsclc ◽

Nsclc Patients

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P2.04-10 Biomarkers of Pathological Response on Neo-Adjuvant Chemo-Immunotherapy Treatment for Resectable Stage IIIA NSCLC Patients

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.1515 ◽

2019 ◽

Vol 14 (10) ◽

pp. S711

Author(s):

R. Laza-Briviesca ◽

A. Cruz-Bermudez ◽

M. Casarrubios ◽

E. Nadal ◽

A. Insa ◽

...

Keyword(s):

Pathological Response ◽

Stage Iiia ◽

Iiia Nsclc ◽

Nsclc Patients

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Trimodally treatment for stage IIIa NSCLC patients increases survival while not effecting surgical mortality or complexity

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-018-0829-z ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Dan Aravot ◽

Yaron D. Barac ◽

Efrat Krutzwald-Josefson ◽

Aaron M. Allen ◽

Dov Flex ◽

...

Keyword(s):

Surgical Mortality ◽

Stage Iiia ◽

Iiia Nsclc ◽

Nsclc Patients

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Temporal trend in the use of surgery in the management of stage IIIa non-small cell lung cancer (NSCLC) between 2000-2013: A SEER analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.8524 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 8524-8524

Author(s):

Veena Iyer ◽

Hosam Hakim ◽

Arindam Bagchi ◽

Qiang Nai ◽

Danae Hamouda ◽

...

Keyword(s):

Lung Cancer ◽

Survival Rates ◽

Relative Survival ◽

Tumor Grade ◽

Geographic Region ◽

Stage Iiia ◽

N2 Disease ◽

Time Period ◽

Iiia Nsclc ◽

Nsclc Patients

8524 Background: The optimal treatment of patients with Stage IIIA NSCLC, a heterogeneous group comprised of T1-T4, N0-N2 disease, is controversial. Lack of clear data and guidelines allows several options for treatment, and hence there has been significant variability in clinical practice. The purpose of this study was to evaluate the nationwide trends in rates of surgery for Stage IIIA lung cancer diagnosed between 2000-2013. Methods: The study included patients with Stage IIIA NSCLC, 18 years and older diagnosed between 2000 and 2013. We used Z-tests in SEER*Stat to compare relative survival rates for patients diagnosed between 2000-2010. Results: Among the 27,697 patients with Stage IIIA NSCLC, 45% were females and median age was 67. 35% were treated with surgery. Multivariate analysis demonstrated that year of diagnosis, race, marital status, geographic region, tumor size, tumor grade, nodal status all were significantly associated with the use of surgery. Relative survival at 24 months (RS24) was 62% for patients who had surgery and 29% for patients without surgery (z = -47.3). The proportion of patients receiving surgery decreased from 55.6% in 2000 to 32.6% in 2010 and 29.7 in 2013 (p < 0.0001) while the relative survival at 24 months (RS24) from 2000 to 2010 rose from 34.7% to 43.2% (z = -4.89). The RS24 for patients who received surgery rose from 55.3% in 2000 to 77.6 % in 2010 (z = -3.58). Change in RS24 for patients who did not have surgery also improved from 19.6% to 31.2%. The median RS of the surgical cohort changed from 28 m to 44 m. Conclusions: Based upon reporting within the SEER database, the proportion of stage IIIA NSCLC patients undergoing surgery has decreased over the study time period. However, the relative survival rates have improved significantly for both the overall group and those having surgery, suggesting that significant strides have been made both in selecting the group of patients who would benefit from surgical resection and in the overall management of this group of patients.

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