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- W2276394433 abstract "7588 Background: Previous studies have assessed prognostic factors for advanced NSCLC. This international observational study quantifies the effect of a set of clinically relevant prognostic markers into a single model that tests continued smoking during therapy on survival, and allows for an evidence-based approach to determining prognosis in patients (pts) with advanced NSCLC receiving first-line chemotherapy with a gemcitabine-platinum combination. Methods: Eligibility criteria included: Stage IIIB/IV NSCLC, no prior chemotherapy, and ECOG performance status (PS) 0 or 1. A Cox regression model was constructed and validated by splitting the data at random into two datasets in a ratio of 3:1 (Construction [C]: Validation [V]). Country, disease stage, hypercalcemia, “N” factor, weight reduction, PS, and superior vena caval obstruction (SVCO) were pre-defined variables that were forced into the model. Other variables were selected based on significance at P<0.1 or clinical opinion. Continued smoking was then tested with adjustment for these variables. Results: 1,214 (C=891 and V=323) pts were enrolled. The primary model was estimable on 544 pts, with Hazard Ratios (* implies P<0.05): Country vs. Taiwan: China 1.04, Egypt* 1.91, Israel 1.48, Pakistan 1.37, Poland/Romania 1.30, Sth Korea 0.87, Turkey 1.28; disease stage* IV vs. IIIB: 1.59; hypercalcemia: 0.51; N-staging vs. N0: N1 1.51, N2 1.18, N3 1.49, NX 2.01, weight loss >10% 1.08, PS* 1 vs. 0: 1.66, SVCO 1.77, carboplatin vs. cisplatin*: 1.51, T-staging* vs. T1: T2 2.52, T3* 3.75, T4* 4.01, TX* 7.32, sex F vs. M 0.78, brain metastasis 1.38, and histopathology vs. adenocarcinoma: large cell* 1.77, mixed 0.62, squamous 1.19, NSCLC 1.13, COPD 1.33. Smoking during therapy was not significantly associated with survival (46/508 assessable pts smoked), HR: 1.06 (95% CI: 0.68, 1.65), P=0.78. The model performed well under validation in different centers (P=0.0008). Conclusions: After adjusting for other prognostic markers, continued smoking during therapy did not statistically significantly effect survival, though too few smoked to rule out a clinically important effect. This model forms an evidence-based approach to assessing prognosis in advanced stage NSCLC. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Eli Lilly Eli Lilly Eli Lilly" @default.
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- W2276394433 date "2008-05-20" @default.
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- W2276394433 title "Smoking and prognostic factors in an observational setting in patients with advanced non-small cell lung carcinoma (NSCLC; B9E-AA-B004)" @default.
- W2276394433 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.7588" @default.
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