key: cord-0760959-dt4s3k5f
authors: Hasegawa, K.
title: MA07.09 Lung Cancer Patients Survey Under COVID-19 Epidemic
date: 2021-03-31
journal: Journal of Thoracic Oncology
DOI: 10.1016/j.jtho.2021.01.189
sha: 1962d13d6b0b3523ecd6b3a07070aecfab818b5c
doc_id: 760959
cord_uid: dt4s3k5f

nan

U. Basu Roy, M. Jacobson, J. Selig Research, Lungevity Foundation, Chicago/IL/US Introduction: Lung cancer (LC) patients are especially vulnerable to developing severe forms of COVID-19, due to patient-specific factors (smoking history or immunosuppressive treatments) and the disease's impact on the lungs. After COVID-19 was declared a global pandemic, US states issued shelter-in-place/lockdown orders that began to be lifted around late May 2020. We analyzed whether LC patients are prepared to navigate healthcare in the post-shelter-inplace era. Methods: A rapid needs assessment survey was deployed to a national online sample of LC patients/caregivers from June 10-June 25, 2020. The survey contained questions on patient worries about access to LC care, patient preparedness to navigate care, and information needs. Descriptive statistics were used to understand frequencies and means. Relationships between categorical variables were measured using X 2 analysis. Results: Of the 302 respondents, 97% were NSCLC patients, 33% lived in COVID-19 hotspots, 64% were below the age of 66 (younger group), and 61% were in active treatment whereas 30% were NED/Cured. 1. Forty-six percent reported interruption in LC care [not seeing their doctors (23%) and increased difficulty in receiving appropriate LC care (18%)]. Younger patients reported a higher difficulty in accessing care (53% vs 34% reported by older patients e p<0.05) 2.Overall, 96% of respondents were concerned that the pandemic will affect their cancer care. This is more apparent in younger patients and those living in COVID-19 hotspots (Figure) 3. Forty-five percent of respondents worry about accessing care post-shelter-in-place. Of note, NED/Cured patients are more worried than those in active treatment due to fear of recurrence (Figure) . 4. Two-thirds spend between 1-4 hours/week reading or listening to information about COVID-19. Older patients and those living in COVID-19 hotspots were more likely to spend greater than 4 hours per week seeking information. Respondents rated information from their physicians or patient advocacy groups as most reliable (mean reliability score MRS ¼ 6.2; 0 ¼ Not Useful and 10 ¼ Very useful). Online sources were the least reliable (MRS ¼ 2.9) 5. Respondents living in COVID-19 hotspots or in active treatment felt the least prepared about their LC care plan in the postshelter-in-place era ( Figure) .

Conclusion: Our study reveals that LC patients continue to feel vulnerable and ill-equipped to navigate cancer care post-shelter-inplace. Indeed, patient-specific factors (age and treatment status) and local COVID-19 caseload are important predictors of patient worries and access to healthcare and should be taken into account both during patient-physician discussions and planning LC care at a systems-level. Keywords: COVID-19, Access to care

K. Hasegawa Japan Lung Cancer Alliance, Japan/JP Introduction: Disaster lowers adherence to both treatment and drug of people with chronic diseases including lung cancer patients, which affects health outcome directly. COVID-19 detected in Wuhan, China on December 18, 2019 has spread throughout Japan. On February 26, 2020 Japanese government recommended closing schools and requested refraining from commuting and gathering. Whereas lung cancer patients are COVID-19 high-risk group, they need cancer treatment. The purpose of this study is to investigate actual condition of lung cancer patients in terms of adherence decrease and concerns about their treatment. Methods: Survey was conducted through website from March 6 to 11, 2020. 354 lung cancer patients and families answered questionnaires regarding not only adherence to treatment and drug, but also concerns about cancer treatment and daily life. Results: Out of 267 patients and families under treatment, 55.1 percent have trouble or concern about cancer treatment, 96.0 percent not experienced treatment or doctor consultation postponement for hospital convenience, 95.1 percent not experienced treatment or doctor consultation postponement for patients' convenience, and 99.9 percent continue drug compliance. Regarding daily life concerns, 75.7 percent of under treatment and 74.7 percent of not-under treatment have concerns whether going outside causes infection. 55.1 percent of patients and families under treatment have concerns for using train or bus, 48.7 percent of patients and families under treatment have concerns of virus brought into home by families. For above concerns, higher percentage are shown in under treatment than in not-under treatment. 54.0 percent of not-under treatment feel they have to go out despite their worries about infection. 40.2 percent of not-under treatment wonder what to do because of lack of information for lung cancer patients. For above concerns, higher percentage are shown in not-under treatment than in under treatment. Conclusion: While treatment was provided smoothly even at the period of social life limitation, half of lung cancer patients felt anxious for treatment. This survey also reveals patients not-under treatment feel more anxious. The author concludes patient support group will lead to provide information valuable for patients. Keywords: COVID-19 MA08.03 Immunotherapy Alone or with Chemotherapy in Advanced NSCLC? Utility of Clinical Factors and Blood-Based Host Immune Profiling.

Introduction: Immune checkpoint inhibitors (ICI) have revolutionized cancer care with greater overall survival (OS) in patients with advanced stage non-small cell lung cancer (aNSCLC). However, even for patients with good ECOG performance status (PS) 0-1 and high PD-L1 expression, the overall response rate to single-agent ICI in the treatment naïve population is only 45%. Combination treatments might increase efficacy but add toxicity and higher cost. Better predictors of response to treatment are needed to guide treatment decisions. A prospectively designed, observational study assessed the ability of clinical factors and a clinically validated, blood-based, host immune classifier (HIC) to predict ICI therapy outcomes. Methods: Over 3,500 NSCLC patients at any stage and line of therapy across 33 US sites have been enrolled in the prospective observational study (NCT03289780) that assesses subject sera by the proteomic HIC test (HIC-Hot or HIC-Cold) prior to treatment initiation. An interim analysis was performed after 12-18 months follow-up with the first 2,000 enrolled subjects. The correlation of various factors, including PD-L1 expression, age, histology, PS, smoking history, gender and the HIC result, with OS of subjects receiving ICI alone (ICI, n¼86) or in combination with platinumdoublet chemotherapy (ICI+PD, n¼98) was assessed. Results: In a realworld clinical setting, OS of subjects with newly diagnosed aNSCLC did not differ significantly between ICI and ICI+PD (median OS (mOS): 9.4 vs. 12.5 months, hazard ratio 0.80 [95% confidence interval: 0.54e1.19], P-value¼0.28). Survival analysis for subjects receiving ICI indicated that HIC-Hot, better PS and younger age, but not high PD-L1 expression (either 50% or 90% cutoff) were significantly associated with longer OS according to univariate analyses (see table) . When adjusted for covariates in a multi-variate analysis, HIC and age remained significant predictors of OS (p¼0.0006 and p¼0.005), while PS did not (p¼0.40). For patients receiving ICI+PD, only high PD-L1 expression was significantly associated with increased OS. While HIC individually trended towards significance, its inclusion in a multivariate analysis of gender, smoking history (ever vs. never) and PD-L1 expression (<50% vs. 50%) did not improve the fit, indicating that HIC is not independently associated with OS in subjects receiving ICI+PD (p¼0.27). Conclusion: The HIC test provides clinically meaningful information in addition to currently utilized clinical factors to potentially help guide immunotherapy treatment decisions for patients with newly diagnosed aNSCLC. HIC stratified survival for patients receiving ICI but not ICI+PD, suggesting that patients classified HIC-Cold may benefit from addition of chemotherapy to ICI. Keywords: Blood-based immune profiling, Immunotherapy, Advanced non-small cell lung cancer 

12 E. Schaefer 13 1 Medical Oncology

Fort Worth/TX/US, 6 Karmanos Cancer Inst Wayne State Univ, Detroit/MI/US, 7 "lewis & Faye Manderson Cancer Center at Dch Regional Medical Center

Age <65 years (N[38)

PD-L1 ‡90% (N[29)