1420P Real-life Management of Octogenarians with NSCLC in a French Nationwide Cohort

Due to scarce publications, no specific recommendations have been published for the management of octogenarians with NSCLC. In a real-life prospective observational, multicenter study we analyze their clinical and biological characteristics, modalities of treatments by stage, overall survival (OS) and its evolution in ten years. Between 01/01 and 12/31/2020, all patients diagnosed with a Lung Cancer (LC) in 82 participating centers, were included in a nationwide cohort (KBP-2020). Here, we report data on octogenarians with NSCLC compared to those under 80 y.o (<80). OS was calculated using the Kaplan-Meier method. Management and OS were compared to the previous cohort (KBP-2010). 8,999 LC were included in KBP-2020, 1026 (11.4%) were NSCLC over 80 y-o. Median age was 83.7, 33.7% were female, 40.0% had a PS≥2 (vs 21.9% in <80), 61.2% had lost weight (mean 6.8kg) at diagnosis (vs 53.2% in <80), 32.2% were non-smokers (vs 10.8 % in <80), 62.7% had an adenocarcinoma. By stage, there were 19% localized (N=188), 18.8% locally advanced (N=186) and 62.2% metastatic (N=615) disease. Biomolecular analysis was performed in 65% of cases.Table: 1420PGeneEGFRKRAS G12CMET ex14BRAF V600EHER2RETALKROS1N+/ N tested%N+/ N tested%N+/ N tested%N+/ N tested%N+/ N tested%N+/ N tested%N+/ N tested%N+/ N tested%NSCLC ≥80 y141/55325.552/38113.625/21911.414/3643.89/2933.12/692.911/5591.97/4881.4NSCLC <80 y379/342611.1520/274119.039/16162.481/25533.235/20131.710/5611.894/39232.461/33651.8 Open table in a new tab Compared to KBP-2010, in octogenarians, surgery was performed in 46.3% of localized disease (vs 26%), thoracic radiotherapy or chemotherapy in 33.3% (vs 25.5%) and 38.9% (vs 41.5%), respectively of locally advanced disease and systemic therapy was given in 55.7% of metastatic disease (vs 52.1%). Chemotherapy, targeted therapy or immunotherapy were performed in 25.4%, 18.2% and 14.9% of metastatic patients, respectively. In 2020, median OS for all NSCLC octogenarians was 8.7 months [7.0 - 9.9] vs 5.0 months [4.6 - 5.8] in 2010. Compared to youngest patients, octogenarians more often had a PS≥2, lost weight, were non-smokers, had an EGFR or a MET exon 14 mutation. Compared to 2010, in 2020 surgery was performed more frequently as targeted therapy and immunotherapy while chemotherapy was less often offered resulting in better OS.