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Conclusion

IS SECOND LINE SYSTEMIC CHEMOTHERAPY BENEFICIAL IN PATIENTS WITH NON-SMALL CELL LUNG CANCER (NSCLC)? : A MULTICENTER DATA EVALUATION (ANATOLIAN SOCIETY OF MEDICAL ONCOLOGY )

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Conclusion

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  1. IS SECOND LINE SYSTEMIC CHEMOTHERAPY BENEFICIAL IN PATIENTS WITH NON-SMALL CELL LUNG CANCER (NSCLC)? : A MULTICENTER DATA EVALUATION (ANATOLIAN SOCIETY OF MEDICAL ONCOLOGY ) Hatice Odabas1, Arife Ulas2, Kubra Aydin1, Mevlude Inanc3, Asude Aksoy4, Dogan Yazilitas5, Mehmet Turkeli6, Sinemis Yuksel1, Ali Inal7, Ahmet S. Ekinci2, Alper Sevinc8, Nebi S. Demirci9, Mukremin Uysal10, Necati Alkis2, Faysal Dane11,Mahmut Gumus1; 1Kartal Dr.Lutfi Kirdar Research and Training Hospital, Istanbul/TURKEY, 2Abdurrahman Yurtaslan Oncology Hospital, Ankara/TURKEY, 3Erciyes University Hospital, Kayseri/TURKEY, 4Inonu University Hospital, Malatya/TURKEY, 5Konya Research and Training Hospital, Konya/TURKEY, 6Ataturk University Hospital, Erzurum/TURKEY,7Dicle University Hospital, Diyarbakir/TURKEY, 8Gaziantep University Hospital, Gaziantep/TURKEY, 9Ankara Numune Research and Training Hospital, Ankara/TURKEY, 10Kocatepe University Hospital, Afyon/TURKEY, 11Marmara University Hospital, Istanbul/TURKEY Background Results Overall, the data of 904 patients (31% female and 75% < 65 years old) were evaluated. Median follow up was 13 (2-197) months. The rate of adenocarcinoma, squamous cell carcinoma, and NSCLC-NOS were 46%, 32%, and 22%, respectively. At diagnosis, 22% of patients had stage 3B, and 78% had stage 4 disease. Single agent docetaxel was preferred the most as a second-line therapy (21%). Table 1: Patient characteristics The survival analysis showed that median PFS and median OS were 4 months (SD: 0.2; 95% CI: 3.6-4.3), and 7 months (SD:1: 95% CI: 6-8), respectively. In univariate analysis, performance status, normal hemoglobin level, having stage 3B at diagnosis, response to first line therapy, and PFS of 3 months or longer after first line therapy were found to be significant for overall survival after second line therapy (p values <0.05). Although NSCLC patients have a very poor prognosis, they generally need a second line therapy. Studies have shown that both systemic chemotherapy and targeted therapies are useful in this setting. To determine the patients who would get benefit from second line therapy may increase the success rate of the treatment. In this multicenter study, we aimed to evaluate the parameters that determine the benefit of second line treatment in NSCLC. Header Figure 1-3: Overall survival curve for performance status before second line therapy, hemoglobin level and response to first line treatment (p=0,0001, p=0,0001 and p=0,001 respectively). PD: Progessive disease, OR: Objective response Methods and Materials In multivariate cox regression analysis, good performance status, normal hemoglobin level, and response to first line therapy were independent prognostic factors for survival (p<0.0001, p<0.0001, and p=0.001, respectively). Records of NSCLC patients who received second line systemic therapy in 11 centers from Turkey were evaluated retrospectively. Age, gender, histological subtype, stage at diagnosis, performance status, serum hemoglobin level, serum lactate dehydrogenase level, response to first line therapy, platinum sensitivity, and progression free survival after first line therapy were investigated whether they have any role in detecting the usefulness of second line therapy. Additionally, PFS and OS after second line therapy were analyzed. Conclusion Our findings revealed that second-line therapy is beneficial in patients who have good performance status and who responded to the first-line therapy. Detecting the parameters that predict the usefulness of second-line therapy may increase the success rate and guide the selection of patients for this therapy.

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