Key concerns and symptoms of patients undergoing second- and third-line treatment for non-small cell lung cancer: Findings from a patient interview study.

63 Background: Understanding key concerns and symptoms of patients undergoing cancer treatment is important for characterizing drug treatment benefit as well as developing appropriate psychosocial support interventions. The purpose of this interview study of patients undergoing second and third line therapy for non-small cell lung cancer (NSCLC) was to characterize their physiological, especially pulmonary, symptoms, functional impacts, emotional distress, health-related quality of life (HRQOL), and coping strategies. Methods: Semi-structured thematic interviews with 20 patients in second and third line treatment for advanced NSCLC. Interviews included open elicitation of NSCLC symptoms, their functional impact, and coping strategies. Results: Mean age was 62 years (range 30-79); 80% of patients had non-squamous histology, and 25% had co-morbid COPD. Patients described a range of core symptom experiences, severity, functional impacts, and coping strategies. Shortness of breath (reported by 16/20, 13/20 rated as very important), cough (reported by 14/20, 10/20 rated as very important), and chest tightness (reported by 15/20, 9/20 rated as very important) emerged as key pulmonary symptoms. Ninety percent (18/20) of patients reported tiredness or fatigue, mostly as “very important.” A quarter (5/20) of the patients reported having no pulmonary symptoms. The symptom importance ratings were influenced by the symptom’s impact on valued roles and responsibilities. Patients reported diverse coping strategies including breaking down activities into manageable tasks, priority setting, using physical assistance, emotional support, and adoption of diet/exercise changes. Conclusions: Findings from this interview study of patients receiving second and third line treatment for advanced NSCLC reveal the importance and relevance of core physiological, especially pulmonary, symptoms in characterizing the benefits of drug therapies. These findings offer insights to the patient education and psychosocial interventions that are likely to enhance patients’ HRQOL.

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Apatinib plus icotinib in treating advanced non-small-cell lung cancer after icotinib treatment failure.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e20528 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e20528-e20528

Author(s):

Jianping Xu ◽

Xiaoyan Liu ◽

Sheng Yang ◽

Xiangru Zhang ◽

Yuankai Shi

Keyword(s):

Lung Cancer ◽

Treatment Failure ◽

Advanced Nsclc ◽

Small Cell ◽

Toxic Effects ◽

Line Treatment ◽

Small Cell Lung ◽

Line Therapy ◽

Third Line ◽

Third Line Treatment

e20528 Background: Icotinib, a small-molecule EGFR TKI, has been approved as the first-line therapy for treating advanced non-small-cell lung cancer (NSCLC) in China. However, treatment failures frequently occurred in NSCLC patients with EGFR-sensitizing mutations. A phase II clinical trial has reported the beneficial survival of apatinib, a new small-molecular VEGFR TKI, in treating NSCLC (Zhang et al. 2012 ASCO, 7548). This retrospective study tried to investigate the efficacy and safety of apatinib plus icotinib as second- or third-line treatment in patients with advanced NSCLC. Methods: This study comprised 27 patients diagnosed with advanced NSCLC and treated with icotinib and apatinib as the second- or third-line therapy. Patients received oral icotinib (125 mg, tid), alone initially. When disease progressed, they received icotinib plus apatinib (500 mg, qd, orally). Treatment was continued until disease progression or unacceptable toxic effects. Efficacy was evaluated based on RECIST version 1.0 and toxic effects were assessed using the NCI-CTC version 2.0. Results: Followed up to December, 2016, the median time of apatinib treatment was 7.47 months, and 8 of 27 patients were dead. The median overall survival had not reached and the median progression-free survival (PFS) was 5.33 months (95% CI 3.63-7.03 months). Moreover, the objective response rate (ORR) was 11.1% and the disease control rate (DCR) was 81.5%. Fourteen patients received icotinib and apatinib as the second-line treatment, and the RR and DCR were 7.1% and 78.6%. The remaining 13 patients received drugs as the third-line treatment, with an ORR and a DCR of 15.4% and 84.6%. Additionally, 11 patients experienced icotinib monotherapy failure within 6 months with median PFS of 7.37 months (95% CI 4.17-8.57 months) and 16 patients experienced icotinib monotherapy failure after 6 months with median PFS of 2.60 months (95% CI 0.00-8.54 months). The common drug-related toxic effects included hypertension (44.4%), fatigue (37.0%) and hand-foot syndromes (18.5%). Conclusions: Apatinib plus icotinib is efficacious in treating patients with advanced NSCLC after icotinib treatment failure, with acceptable toxic effects.

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