95P Neoadjuvant treatment pattern and association between real-world event-free survival (rwEFS) and overall survival (OS) in patients (pts) with resected early-stage non-small cell lung cancer (eNSCLC)

This study aimed to describe neoadjuvant treatment patterns, rwEFS, OS and assess association between rwEFS and OS in resected eNSCLC. This retrospective study used the US SEER-Medicare data (2007–2019) to select pts with newly diagnosed, resected, stage II-IIIB (N2) NSCLC (AJCC 8th edition) treated with neoadjuvant therapy. Index date was defined as neoadjuvant therapy initiation. rwEFS (time from index date to first recurrence or death, whichever first) and OS (time from index date to death) were described using Kaplan-Meier analysis and correlation was assessed using normal scores rank test. OS was compared between pts with and without recurrence by 1, 2, and 3-year landmarks after index date; hazard ratios were estimated using Cox models adjusted for key baseline factors. 221 pts (156 with recurrence and 65 without) met eligibility criteria (median follow-up: 32.7 months). Selected pt characteristics are presented in the table. ~97% received platinum-based neoadjuvant therapy and ~49% received neoadjuvant chemoradiation. Carboplatin + paclitaxel, cisplatin + etoposide, and carboplatin + pemetrexed are most frequently used regimens. Median rwEFS was 17.6 months; median OS was 48.5 months. The normal scores rank correlation demonstrated a statistically significant correlation between rwEFS and OS (0.68; P < 0.001). Pts with recurrence by each landmark had significantly shorter OS than those without recurrence (All Ps <0.01). Adjusted Cox models indicated that pts with recurrence had 2.7–3.2 times increased risk of death (All Ps <0.05). Table 95PSelected characteristics, rwEFS and OS among patients with early-stage, resected NSCLC who have received neoadjuvant therapyPatient characteristicsAge at surgery (years), mean ± SD72.1 ± 4.9Male, N (%)126 (57.0%)White191 (86.4%)Adjuvant chemotherapy, N (%)67 (30.3%)Post-operative radiotherapy, N (%)56 (25.3%)rwEFS rate1-year61.1%2-year42.4%3-year33.3%4-year26.9%5-year20.9%OS rate1-year91.4%2-year72.4%3-year60.6%4-year50.3%5-year44.9%NSCLC: non-small cell lung cancer; rwEFS: real-world event-free survival; OS: overall survival; SD: standard deviation. Open table in a new tab NSCLC: non-small cell lung cancer; rwEFS: real-world event-free survival; OS: overall survival; SD: standard deviation. Among pts with resected eNSCLC receiving neoadjuvant therapy, poor survival outcomes were observed. rwEFS is positively and significantly associated with OS. These findings highlight the need for and importance of more effective treatments for this pt population.