e21720 Background: Lung cancer has the highest mortality rate among malignant neoplasms worldwide. Most cases present an advanced stages. From the last few years, the target drugs and immunotherapy (IO) have emerged as important therapeutic options in this scenario. In Brazil, in 2018, this disease was responsible for 8.7% of cases of malignant neoplasms in men and 6.2% of cases in women. When looking at data from our state, Rio Grande do Sul, the highest rates in the country are noted, with an estimated rate of 40.22 cases for every 100 thousand men and 20.49 cases for every 100 thousand women. Although the available trials point to significant improvements in the clinical outcomes, the real impact of using such treatments on patients in our community practice, real-world scenario, is unknown. Methods: Through the detailed analysis of the institutional electronic medical record, we included patients with metastatic NSCLC, followed up on an outpatient basis at the Oncology Center of Hospital Moinhos de Vento, who had received at least one dose of nivolumab, pembrolizumab or atezolizumab, either as monotherapy or in combination therapy with chemotherapy, in any line of cancer treatment, in the period from January 2015 to June 2019. Primary endpoint was overall survival (OS) and secondary endpoints were time-to-treatment discontinuation (TTD) and treatment-related toxicity (TRT). Results: 41 patients met criteria. The sample consisted of patients with a mean age at diagnosis of 67.7 years, the majority being male (53.7%), stage IVB disease (53.7%), previously smokers (61%) and with non-squamous NSCLC (75.6%). Central nervous system (CNS) metastases were present in 26.8% of patients. About 51.3% (n = 21) received IO as second line or later treatment. At this group, nivolumab was the main IO (81%). The median OS in the first line (1L) of treatment was not reached while in second line and beyond was 10.0 months (3.4 - 16.5), with no statistical difference (p = 0.071). The median TTD was higher in patients whose received IO at 1L (17.0 months vs 7.0 months, p = 0.045). Pneumonitis was the main toxicity being present in 7.1% of patients. Colitis, thyroiditis and hepatitis were seen in one patient each. Conclusions: in general, we were able to observe that in our real-world scenario, IO is well tolerated, regardless of the treatment line. In addition, OS met the findings of the landmark clinical trials.
Background: PRO have been shown to enhance our ability to communicate with patients and to control their symptoms. There are data that suggest a positive impact on survival when there is active participation of the patient in the reporting of symptoms. However, PRO data are not commonly collected in routine cancer care due to challenges like cost and due to the obsolete technology of many existing electronic health records. Methods: in an effort to bridge the unmet needs of PRO collection and integration into routine cancer care, we developed a symptom monitoring and management system that was launched as a free mobile app in August, 2018. Tummi app is designed for reporting 28 symptoms based on the National Cancer Institute’s Common Terminology Criteria for Adverse Events. Symptoms are reported in a 3-point scale (mild, moderate, severe) and patient reported an overall well-being scale represented by emojis. Tummi has the ability to record symptoms, summarize the reporting in physical printout, and automatically store and analyze the input symptoms into graphical interpretations. Results: since august 2018, 281 patients with the diagnosis of invasive breast cancer, during their treatment, downloaded and enjoyed the app. The most common side effect registered was back pain. When assessing the most intense symptoms reported by patients (grade 3), insomnia appears as the most remembered, followed by headache. Regarding general well-being reports, patients totaled 4501 records. Of these, at 62.40% of the time the patients were well, while at 33.16% they were average and at 4.44% they felt bad. Conclusions: in this group of patients evaluated by the Tummi App, insomnia is the most disturbing symptom. Although it appears in the literature as quite prevalent in this scenario, we see that its approach to day-by-day oncology clinics is far from ideal. We believe that the monitoring by a PRO tool can lead to a greater effort to improve this symptom that has such an impact on the quality of life of our patients. Citation Format: Alessandra Menezes Morelle, Fernando Castilho Venero, Rafael DalPonte Ferreira, Rommel FabricioPereirada Silva, Pedro Tofani Sant'Anna. Insomnia is the most disturbing symptom during breast cancer treatment: Results from a Brazilian cohort using a patient-reported outcomes: PRO tool - Tummi App [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-60.
e18807 Background:Since December 2019, the world is facing a pandemic caused by a novel coronavirus (SARS-CoV-2). We sought to analyze the behavior of cancer treatments and procedures in breast cancer in Brazil after the beginning of the COVID-19 pandemic through an artificial intelligence platform with real life data. Methods:Data evaluation was performed using the TechTrials platform. This platform created a unique healthcare data warehouse containing hundreds of different publicly available data sources about Brazilian Public Health System and with proprietary technology, developed several analytics products that explore and release real-world data (RWD) insights. For this analysis data were extracted from DATASUS – SIA (outpatients information system). For each outcome, data from January 2011 to February 2020 were used to adjust a time series to predict values for March to November 2020. Those values were compared with the observed ones. Results: Biopsies, mammograms and procedures showed a sharp decrease (41.9%, 73.7% and 31.1%, respectively), in April 2020 (following month of the first COVID-19 case in Brazil) with some recovering in the following months. All observed values of biopsies, the number of mammograms from March to October and the number of procedures in April and May were significantly smaller than the predicted ones. Number of women undergoing chemotherapy began to decline in August and remained falling until the last month of available data.(Table). Conclusions: This study is the first one that analyzes RWD of breast cancer screening, diagnosis and treatment in Brazil as a result of the COVID-19 pandemic. The impact of the decrease observed in screening and diagnosis is already evident in the number of women undergoing chemotherapy. These data will continue to be monitored in the coming months when only then will data be available for staging at diagnosis.[Table: see text]
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