Patterns of recurrence among adults diagnosed with screen-detected lung cancer

CHEST(2023)

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Abstract
SESSION TITLE: Lung Cancer Posters 1 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Lung cancer remains the leading cause of cancer death in the US and many cancer-related deaths are caused by recurrent disease that develops among patients who previously completed definitive therapy and were declared disease free. Little is known if the implementation of lung cancer screening (LCS) has impacted the proportion of lung cancer recurrence and survival after recurrence in community settings. We aimed to describe recurrence among patients with screen-detected lung cancer compared to patients with non-screen-detected lung cancer. METHODS: We identified patients between 50 and 80 years old diagnosed with stage I-IIIA lung cancer between 1/1/2014 and 12/31/2020 who completed definitive therapy and were declared disease free in 5 healthcare systems in the Population-based Research to Optimize the Screening Process Lung Consortium (PROSPR-Lung). Patients had to be engaged with the healthcare system at the time of primary diagnosis and survive at least 30 days post definitive therapy. Recurrence status was obtained from tumor registry data and supplemented with an algorithm that detects probable recurrence. We used Restricted Mean Survival Time (RMST) to describe disease progression measures and adjusted for sex, age, race and ethnicity, smoking status at the time of primary diagnosis, BMI, first course treatment, stage, histology, year of diagnosis, and healthcare system. RESULTS: Analyses included 896 patients: 18% received a Low Dose Computed Tomography (LDCT) scan for LCS prior to their lung cancer diagnosis and were considered Screen Detected lung cancers (SDLC). The proportion of patients with non-small cell histology was 98.1% for non-Screen Detected lung cancers (NSDLC) and 97.5% of patients with SDLC (p=0.60). The proportion of patients who developed recurrence of any type after being treated was 19.2% for NSDLC and 19.1% for SDLC (p=0.98) through median follow-up of 44 months. Distant recurrence occurred in 8.9% of the NSDLC and 7.0% of the SDLC (p=0.15). RMST of definitive therapy to recurrence through 24 months for SDLC and NSDLC was 22.5 and 22.2 months, respectively (p=0.46). RMST of recurrence to death was 15.7 and 13.4 months (p=0.22). Overall RMST of definitive therapy to death was 23.7 and 23.4 months (p=0.15). CONCLUSIONS: The proportion and type of recurrence detected between SDLC and NSDLC did not differ. While patients with SDLC survived longer than patients with NSDLC, it was neither clinically nor statistically different. Further study with larger sample size and longer follow-up is needed. CLINICAL IMPLICATIONS: These findings will be important for future cost effectiveness models. DISCLOSURES: No relevant relationships by Andrea Burnett-Hartman Received institutional research support relationship with Pfizer Please note: 1/1/2022-current Added 03/31/2023 by Nikki Carroll, source=Web Response, value=Grant/Research No relevant relationships by Robert Greenlee No relevant relationships by Stacey Honda Grantee relationship with Genentech Please note: Jan 2021-Dec 2023 Added 03/31/2023 by Christine Neslund-Dudas, source=Web Response, value=Grant/Research Support Received research funding relationship with Pfizer Please note: 01/2020-12/2022 Added 03/31/2023 by Katharine Rendle, source=Web Response, value=Grant/Research Support Received research funding relationship with AstraZeneca Please note: 11/2022 - 10/2024 Added 03/31/2023 by Katharine Rendle, source=Web Response, value=Grant/Research Support Received research funding relationship with AstraZeneca Please note: 11/2022 - 10/2024 Added 03/31/2023 by Katharine Rendle, source=Web Response, value=Grant/Research Support Removed 03/31/2023 by Katharine Rendle, source=Web Response Scientific Medical Advisor relationship with Merck Please note: 2022 Added 03/31/2023 by Katharine Rendle, source=Web Response, value=Consulting fee No relevant relationships by Debra Ritzwoller Scientific Medical Advisor relationship with Johnson and Johnson Please note: 2020 - present by Anil Vachani, value=Consulting fee My spouse/partner as a Researcher relationship with Optellum, Ltd Please note: 2022 - present Added 04/08/2023 by Anil Vachani, source=Web Response, value=Grant/Research Support My spouse/partner as a Researcher relationship with MagArray, Inc. Please note: 2018 - present Added 04/08/2023 by Anil Vachani, source=Web Response, value=Grant/Research Support My spouse/partner as a Researcher relationship with Precyte, Inc. Please note: 2019 - present Added 04/08/2023 by Anil Vachani, source=Web Response, value=Grant/Research Support My spouse/partner as a Researcher relationship with Lungevity Foundation Please note: 2021 - present Added 04/08/2023 by Anil Vachani, source=Web Response, value=Grant/Research Support
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Key words
cancer,recurrence,lung,screen-detected
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