Below you will find three press releases edited by the organizers of the ELCC conference:

  • Further evidence that immunotherapy provides a long-term survival benefit for lung cancer patients;
  • Alectinib provides longer symptom improvement than crizotinib in ALK-positive lung cancer;
  • Coordinating nurses can improve cancer patients’ quality of life and satisfaction during treatment



Further evidence that immunotherapy provides a long-term survival benefit for lung cancer patients

Geneva, Switzerland, 12 April 2018 – Study presented today at ELCC 2018 (European Lung Cancer Congress) in Geneva, Switzerland.

Researchers presented the three-year survival results of the randomised phase 2 POPLAR trial in second line, (1) which is the longest follow-up reported to date with anti-programmed death ligand 1 (PD-L1) immunotherapy in patients with previously treated, advanced non-small-cell lung cancer (NSCLC). The trial randomised 287 patients from 61 sites across 13 countries with advanced NSCLC to the anti-PD-L1 antibody atezolizumab or docetaxel (chemotherapy).

Overall survival was significantly higher with atezolizumab at two and three years compared with docetaxel. Nearly one- third of patients (32.2%) in the atezolizumab treatment group were alive at two years compared with 16.6% in the docetaxel group. Additionally, at three years, almost twice as many patients (18.7%) were alive in the atezolizumab group compared to the docetaxel group (10.0%). The long-term overall survival benefit with atezolizumab over docetaxel was observed across histology (squamous and non-squamous) and regardless of PD-L1 expression. Even patients with PD-L1 expression in less than 1% of tumour cells and less than 1% of immune cells had a promising rate of long-term survival.

The median duration of response was three times longer with atezolizumab (22.3 months) compared to docetaxel (7.2 months). Atezolizumab led to fewer adverse events than docetaxel.

Lead author Dr Julien Mazières of Toulouse University Hospital, Toulouse, France,said: “Nearly one in five patients treated with atezolizumab was alive at three years. This places atezolizumab among the drugs with the highest landmark overall survival in previously treated lung cancer patients.”

“The fact that all subgroups of patients benefitted to a similar degree is good in the sense that atezolizumab can be tried in all advanced NSCLC patients,” hecontinued. “On the other hand, it means that we cannot predict which patients aremost likely to live for three years. We need to find biomarkers to help us identify the long-term survivors with the drug.”

Mazières said the drug was well tolerated which meant that patients can keep taking it for several years. He said: “Someof my patients who were in the atezolizumab treatment group are now long-term survivors with lung cancer. They are not cured, but they have survived, have a good quality of life, and have returned to work. With immunotherapy we now have a new type of patient: long-term survivors with lung cancer who can go back to a normal life.”

Commenting on the study, Prof. Solange Peters, Head of Medical Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland, ESMO President-Elect said: “Before immunotherapy, the long-term survival of non- small-cell lung cancer patients was close to 0%. POPLAR supports the concept that long-term survival is possible with immunotherapy. The three-year survival results of POPLAR are consistent with the three- and five-year survival with the anti-PD-1 antibodies pembrolizumab and nivolumab, respectively, in phase 1 trials. These latest results are exciting because unlike the previous two trials, POPLAR was a large, randomised trial and provides convincing proof that long- term survival now exists in lung cancer.”

Peters said there was now a strong argument that every patient with advanced NSCLC should receive immunotherapy.She said: “In the nivolumab phase 1 trial 15% of patients were alive at five years, which in cancer is usually considered being cured. We should offer all patients this one in six chance of five-year survival. However, this poses a financial challenge for healthcare systems.”

To make this strategy sustainable, Peters said a method was needed to identify the patients who will not benefit fromimmunotherapy. She said: “That would enable us to treat only the patients with a high chance of long-term survival with immunotherapy. POPLAR shows that PD-L1 is not a useful biomarker to exclude patients from immunotherapy, since some patients with very low expression had an overall survival benefit. Rather than a single biomarker, I think it will be asignature of many biomarkers including tumour mutation burden that identifies the patients who should not be treated.”

Peters said trials are needed to assess the ability of a combination of biomarkers to predict which patients with advanced NSCLC do, and do not, survive long-term with immunotherapy: “These trials should be conducted in patients with similarcharacteristics to the long-term survivors in the phase 1 and 2 trials with atezolizumab, pembrolizumab, and nivolumab.

So the first step will be to describe these patients in terms of demographics, smoking history, tumour mutation burden, expression of immune genes, and PD-L1 expression. Focusing future studies on these patients will help us to discover abiomarker signature for use in clinical practice.”

References and notes

1 Abstract 136PD_PR ‘3-year survival and duration of response in randomized phase II study of atezolizumab (atezo) vs docetaxel (doc) in 2L+NSCLC (POPLAR)’: presented by Julien Mazières during the Poster Discussion session ‘Immunotherapy and next-generation TKIs: from second tofrontline treatment’ on Thursday, 12 April, 07:45 to 09:00 (CEST) in Room A.
Journal of Thoracic Oncology, Volume 13, Issue 4, Supplement, April 2018.

Abstract 136PD_PR 3-year survival and duration of response in randomized phase II study of atezolizumab (atezo) vs docetaxel (doc) in 2L+ NSCLC (POPLAR)

J. Mazières1, K. Park2, C. Lewanski3, S. Gadgeel4, L. Fehrenbacher5, A. Rittmeyer6, J.Y Han7, A. Artal-Cortes8, F. Braiteh9, M. Gandhi10, W. Yu10, C. Matheny10, P. He10, A. Sandler10, M. Ballinger10, J. Vansteenkiste11
1Thoracic Oncology, Toulouse University Hospital, Toulouse, France, 2Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 3Charing Cross Hospital, London, UK, 4University of Michigan, Ann Arbor, MI, USA, 5Kaiser Permanente Medical Center, Vallejo, CA, USA, 6Lungenfachklinik Immenhausen, Immenhausen, Germany, 7National Cancer Center, Goyang, Republic of Korea, 8Hospital Universitario Miguel Servet, Zaragoza, Spain, 9Comprehensive Cancer Centers of Nevada, Las Vegas, NV, USA, 10Genentech, Inc., South San Francisco, CA, USA, 11University Hospitals KU Leuven, Leuven, Belgium

Background: Atezo (anti–PD-L1) has demonstrated OS benefit over doc in a randomized Phase II study, POPLAR, in patients with advanced NSCLC. This benefit has been confirmed in the randomized Phase III study OAK (Rittmeyer, 2017). The 3-year survival analysis of the POPLAR study presented here describes the longest survival follow-up reported to date of an all-comer randomized PD-L1/PD-1 immunotherapy trial in 2L+ NSCLC.

Methods: Patients were randomized 1:1 to receive atezo (1200 mg) or doc (75 mg/m2) IV q3w. Tumors were prospectively evaluated for tumor cell (TC) or tumor-infiltrating immune cell (IC) PD-L1 expression using the VENTANA SP142 IHC assay. Landmark OS was estimated using the Kaplan-Meier method. Data cutoff, April 7, 2017; minimum follow-up, 3 years.

Results: The 2-year and 3-year survival with atezo vs doc were 32.2% vs 16.6% and 18.7% vs 10.0%, respectively. The long-term OS benefit of atezo vs doc was observed across histology and PD-L1 expression subgroups (Table). While the TC3 or IC3 subgroup derived the greatest OS benefit, the TC0 and IC0 subgroup also had improved long-term OS with atezo vs doc. The ITT ORR was 15% in both atezo and doc arms, but the median duration of response was 3 times longer with atezo (22.3 months [95% CI: 11.6, 31.1] vs 7.2 months [95% CI: 5.8, 12.2] with doc). Seven of the 11 doc-arm 3-year survivors received subsequent non-protocol therapy with anti–PD-L1/PD-1 agents. Atezo had a favorable safety profile compared with doc that was consistent with previous reports.

Conclusions: Atezo demonstrates superior 2-year and 3-year OS benefit compared with doc, and this benefit is observed across histology and PD-L1 expression subgroups (including TC0 and IC0). Atezo is well tolerated, and responses are highly durable. These results are consistent with long-term OS results from OAK (Satouchi, WCLC 2017).


Clinical trial identification: NCT01903993


Alectinib provides longer symptom improvement than crizotinib in ALK-positive lung cancer

Geneva, Switzerland, 12 April 2018 – Study presented today at ELCC 2018 (European Lung Cancer Congress) in Geneva, Switzerland.

The phase III ALEX trial was a head-to-head comparison of the next-generation tyrosine kinase inhibitor (TKI) alectinib versus the standard of care TKI crizotinib in patients with anaplastic lymphoma kinase (ALK)-positive NSCLC, dependent on a rearrangement of the ALK gene. Approximately 4% of NSCLC patients are ALK-positive and are at high risk of central nervous system (CNS) metastases. Alectinib improved progression-free survival and prolonged the time to CNS progression compared to crizotinib. Alectinib had a better toxicity profile than crizotinib despite a longer duration of treatment. (2)

Patient-reported outcomes in terms of health-related quality of life and lung cancer-related symptoms with alectinib and crizotinib are reported for the first time at ELCC. The EORTC QLQ-C30 questionnaire was used to evaluate health- related quality of life and the EORTC QLQ-LC13 questionnaire was used to assess lung cancer-related symptoms. Patients completed the questionnaires at baseline, every four weeks during treatment, within the four weeks after study withdrawal, and after disease progression. The reasons for withdrawal have been previously reported (2); very few were due to symptom deterioration in either group.

Around two-thirds of patients in both treatment groups completed the questionnaires (66% and 64% in the alectinib and crizotinib groups, respectively). Patients in both the alectinib and crizotinib treatment groups had clinically meaningful improvements in health-related quality of life. However, there was a longer duration of improvement in health-related quality of life for patients treated with alectinib (88 weeks) compared to crizotinib (68 weeks).

For the patients with CNS metastases at baseline, a lower proportion of patients in the alectinib arm had worsening in health-related quality of life compared with crizotinib starting at week four (10.8% vs. 20.6%) and persisting for most assessments through week 84 (0% vs. 16.7 %). In addition, a lower proportion of these patients reported worsening in cognitive function with alectinib compared to crizotinib (17.9% vs. 34.6% at week 32, respectively).

Regarding lung cancer symptoms, there was a clinically meaningful improvement in both treatment arms. But the duration of improvement was longer with alectinib compared to crizotinib (cough: 96 versus 84 weeks; chest pain: 96 versus 80 weeks; fatigue: 96 versus 68 weeks; pain in other parts: 96 versus 68 weeks, respectively).

Fewer patients in the alectinib group reported a clinically meaningful worsening in treatment-related symptoms such as diarrhoea, peripheral neuropathy, constipation, dysphagia, appetite loss, and nausea/vomiting.

Lead author Dr Maurice Pérol, medical oncologist, Centre Léon Bérard, Lyon, France, co-chair of ELCC 2018, said: “The patient-reported outcome data is consistent with the main results of the study. The primary analysis showed a similar response rate for crizotinib and alectinib, but a longer duration of response with alectinib. This is consistent with the improvements in health-related quality of life and lung cancer symptoms, which were of similar magnitude in both groups but lastedlonger with alectinib.”

“The high level of CNS activity shown with alectinib in the primary analysis is consistent with the fact that fewer patients treated with alectinib reported clinically meaningful worsening in health-related quality of life or cognitive functioncompared to crizotinib,” he continued. “Finally, the superior tolerability profile of alectinib compared to crizotinib shown in this analysis is consistent with the adverse events profile recorded during the study.”

Pérol said: “The patient-reported outcome data supports the use of alectinib as a new standard of care in the frontline treatment of patients with ALK-positive lung cancer.”

Commenting on the study, Dr Fiona Blackhall, Honorary Consultant in Medical Oncology, The Christie NHS FoundationTrust, Manchester, UK, said: “The ALEX trial was a practice-changing study that firmly placed alectinib as a first-line palliative treatment for ALK-positive non-small-cell lung cancer patients. This secondary analysis strengthens the rationale for alectinib as the standard of care in first-line treatment.”

Blackhall said that increasingly, because of the cost of conducting clinical trials, patient-reported outcomes are not measured. But she said: “In this context of palliating advanced lung cancer, living better is as important, if arguably not more important, than living longer. And for this reason, patient-reported outcomes and health-related quality of life are crucial to assess and analyse.”

She continued: “In patients with advanced lung cancer the symptom burden is high, particularly cough, breathlessness and chest pain. And so to have meaningful palliation and improvement in symptoms is of paramount importance. So alongside wishing to identify drugs that improve progression-free survival and overall survival ultimately, we need to ensure that those drugs also allow patients to live better. Goals of care are important in the everyday management ofpatients with lung cancer and alleviating the symptoms it causes is a key goal.”

Regarding the impact of alectinib on symptoms in the ALEX trial, Blackhall said: “The time to deterioration in common and difficult to palliate lung cancer symptoms including cough, dyspnoea, and chest pain was comparable between alectinib and crizotinib. However, alectinib prolonged the improvement in those symptoms. That fits in with the previously reported improvement in progression-free survival and favourable tolerability with alectinib.”

References and notes

1 Abstract 138PD_PR ‘Patient-reported outcomes (PROs) in ALEX: A phase III study of alectinib (ALEC) vs crizotinib (CRIZ) in non-small-cell lung cancer (NSCLC)’: presented by Maurice Pérol during the Poster Discussion session ‘Immunotherapy and next-generation TKIs: from second tofrontline treatment’ on Thursday, 12 April, 07:45 to 09:00 (CEST) in Room A.
Journal of Thoracic Oncology, Volume 13, Issue 4, Supplement, April 2018.

2 Peters S, Camidge DR, Shaw AT, et al. Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2017;377(9):829–838. doi: 10.1056/NEJMoa1704795.

Abstract 138PD_PR - Patient-reported outcomes (PROs) in ALEX: A phase III study of alectinib (ALEC) vs crizotinib (CRIZ) in non-small-cell lung cancer (NSCLC)

M. Perol1, S. Peters2, N. Pavlakis3, E. Levchenko4, M. Platania5, J. Oliveira6, S. Novello7, T. Karagiannis8, A. Zeaiter9, R. Dziadziuszko10
1Medical Oncology, Centre Léon Bérard, Lyon, France, 2Centre Hospitalier Universitaire Vaudois - CHUV, Lausanne, Switzerland, 3Royal North Shore Hospital, St Leonards, Australia, 4Petrov Scientific Research Oncology Institute, St- Petersburg, Russian Federation, 5IRCCS MultiMedica Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy,6Medical Oncology, Portuguese Oncology Institute of Porto – IPO Porto, Porto, Portugal, 7University of Turin, Orbassano, Italy, 8Genentech, San Francisco, CA, USA, 9F.Hoffman-La Roche Ltd, Basel, Switzerland, 10Medical University of Gdansk, Gdansk, Poland on behalf of the ALEX author group

Background: ALEC showed superior efficacy versus CRIZ in patients (pts) with treatment-naïve ALK+ NSCLC in the phase III ALEX trial (NCT02075840). PRO data (disease burden, symptom tolerability and health-related quality of life [HRQoL]) are reported here.

Methods: Pts (n=303) were randomised 1:1 to receive ALEC (600mg BID) or CRIZ (250mg BID). Primary endpoint: investigator-assessed PFS. PROs were collected using EORTC QLQ-C30/QLQ-LC13 questionnaires. Pre-specified endpoints: time-to-deterioration (TTD) in lung cancer symptoms and HRQoL, longitudinal analyses of mean score changes from baseline, and proportion of pts with clinically meaningful change (≥10-point change from baseline) during treatment in the ITT population and patients with baseline CNS metastases.

Results: Baseline completion rates and characteristics were balanced between arms in the PRO-evaluable population (ALEC n=100, 65.8%; CRIZ n=97, 64.2%). Median TTD in composite symptom endpoint (cough, dyspnoea, chest pain) was similar between arms (HR 1.10 [95% CI 0.72–1.68]). On average, ALEC pts reported a clinically meaningful improvement in baseline lung cancer symptoms for a longer duration of time versus CRIZ (cough, week 96 vs week 84; chest pain, week 96 vs week 80; fatigue, week 96 vs 68; pain in other parts, week 96 vs 68, respectively). Differences in lung symptoms between treatment arms tended to favour ALEC from 11.1 months (45 weeks), which was around the time of median PFS with CRIZ. ALEC pts reported a clinically meaningful improvement from baseline in HRQoL for a longer duration of time than CRIZ pts (week 88 vs 68, respectively). Fewer ALEC pts experienced a clinically meaningful worsening in treatment-related symptoms (nausea/vomiting, diarrhoea, appetite loss, dysphagia, peripheral neuropathy) than CRIZ pts.

Conclusions: TTD for lung cancer symptoms was comparable between arms. Clinically meaningful improvement in lung cancer symptoms was maintained for longer with ALEC versus CRIZ, consistent with the improved PFS with ALEC versus CRIZ. HRQoL was improved with ALEC versus CRIZ. PRO data are consistent with ALEX safety data and confirm greater tolerability with ALEC versus CRIZ.

Clinical trial identification: BO28984; 15 April 2016


Coordinating nurses can improve cancer patients’ quality of life and satisfaction during treatment

Geneva, Switzerland, 12 April 2018 – Investing in the continuity of care for lung cancer patients can bring tremendous benefits in terms of patient satisfaction and quality of life. In Quebec, Canada, this investment has taken the form of a dedicated role on the medical team: The Pivot Nurse in Oncology (PNO). A study presented at ELCC 2018 (European Lung Cancer Congress) in Geneva has produced new evidence of the different ways in which this service improvespatients’ lives during treatment. (1)

“Introduced to oncology clinics in 2001, the position of the pivot nurse was enshrinedby the Ministry of Health and Social Services of Quebec in 2005 as part of its FightAgainst Cancer campaign,” said study author Elie Kassouf, haematologist and medical oncologist at Centre Hospitalier de Lanaudière (CHDL) in Saint-Charles-Borromée, Canada. “In over 15 years of existence, however, very little data has been collected about its impact on patients’ lives. Our study’s main goal was therefore to determine whether the continuity of nursing care has tangible benefits to patients treated for lung cancer, as compared to the usual standard of care without acoordinating nurse.”

Lung cancer is the number one cause of cancer-related deaths in both men and women. Although progress has been made with treatment, according to Kassouf, increased cure rates and survival have come at the cost of higher toxicity. The multidisciplinary teams required to administer combination therapy have also led to greater complexity in the care process. Quality of life during treatment has deteriorated as a result, and healthcare institutions are increasingly confronted with discontent about delays, service fragmentation or even misinformation – all of which are thought to lead to confusion, distress and compliance issues among patients.

“At the CHUM, patients who enjoy continuity of care have a treating pivot nurse in addition to their treating physician.Each pivot nurse cares for 50 to 60 patients, who all have his or her direct phone number,” Kassouf explained. “The PNO has the patients’ files and can take care of scheduling follow-up appointments with their physician as soon as they receive new test results. If a patient calls to report worrying symptoms, the nurse will also speak directly to their doctor, who may then see that person on short notice without the latter having to go through the regular emergency system.”

To study the efficacy of this service, Kassouf recruited 65 patients with advanced lung cancer at Notre Dame University Hospital in Montreal three months after the start of their treatment. The patients were divided into two cohorts: 82% were assigned to the continuous care (CC) arm, and the 12 individuals who had not had access to a pivot nurse during their treatment constituted the usual care (UC) control group. Patients in both cohorts answered validated patient satisfaction and quality-of-life questionnaires, as well as questions to assess their understanding of their health status. The CC group additionally filled out a specific survey on the role of their pivot nurse.

“The size difference between the two cohorts is because the PNO program has been around for 15 years, and the vast majority of patients in Quebec today have access to a pivot nurse,” Kassouf explained. “The reasons why the studyparticipants in the control group had not used this service three months into their treatment were unrelated to the study.” This made the data more difficult to compare, but, as Kassouf reported, the differences found between the two groups were so wide that the results are statistically significant nonetheless.

“The Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire (PMH / PSQ-D) that we used in thestudy covers four dimensions of a patient’s relationship with his physician: interpersonal skills, empathy, information exchange and quality of time,” said Kassouf. “The score difference we saw between the two cohorts was huge across the board: not because the usual care group scored poorly – their results were similar to those found in other studies based on the same questionnaire – but because the continuous care cohort produced exceptionally high scores.”

In the so-called FACT-L scale, which is a validated questionnaire for evaluating lung cancer patients’ quality of life inCanada, the results also favoured the CC cohort in all categories – including physical, emotional and functional wellbeing – although the difference between the two groups was less marked. “This can be attributed to the fact that, contrary to their level of satisfaction with care, patients’ quality of life is heavily influenced by the disease itself,” said Kassouf.

“A previous study of the PNO system (2) had shown no difference in patients’ quality of life, but most of the nurses in its usual care arm had specialised oncology certifications and over 10 years of experience, which was not necessarily the 

case of the pivot nurses at the time,” he added. “With the generalisation of the PNO program, this asymmetry had disappeared when we conducted our study, so the results are a useful addition to the literature on the subject.”

In their assessment of the PNO service, a large majority of patients stated that they had a better understanding of the course of their disease and treatment side-effects, and that the presence of their pivot nurse gave them more strength intheir fight against cancer. “The only concerns that many people felt were not sufficiently addressed by their PNO were those pertaining to intimacy,” said Kassouf.

Due to its small sample size and confinement to a single hospital, it is difficult to generalise the results of this study. “Earlier data suggests, however, that lung cancer is the malignancy associated with the highest levels of psychologicaldistress compared to other forms of cancer. (3) Presenting more unmet psychosocial needs, these patients could thus be particularly susceptible to the benefits of continuous follow-up and medical scrutiny,” Kassouf remarked. “Our results certainly show that it is an avenue worth exploring.”

Anja Kröner, a PhD-prepared nurse in oncology and member of the management team at the Comprehensive Cancer Centre in Zurich, Switzerland, commented: “Despite the small number of patients involved, which means we must be cautious with the results, this work shows a clear tendency of continuity of care improving when there is an established role similar to that of the pivot nurse on a patient’s medical team,” she said. “In Europe, too, we have seen promising signals: several clinics in Germany, for example, found it was beneficial to assign a case manager to cancer patients.”

Kröner further underlined that the growing complexity of cancer treatment – from surgery to oral therapy and radiation – creates many breaks in the care process. “Parallel to this, we see patients with financial or social burdens who are at particular risk for low adherence to treatment,” she said. “In oral therapy, for example, they have pills to take on their own at home that cause severe side-effects: The routine care process is not very good at detecting individuals who stop taking their medication without telling their doctor about it. That is where pivot nurses can make a real difference.”

According to Kröner, however, cancer patients should not only be satisfied with their doctor, but rather with the entire care setting. “It would be interesting to take the research further by framing patient satisfaction more broadly, as well asconsidering other outcomes alongside quality of life, such as patients’ ability to carry their own weight, or to work, throughout the process,” she added. “In light of the financial pressure faced by many healthcare systems today, it would also be worth exploring whether pivot nurses can reduce the cost of cancer, as another study (4) has already suggested.”

References and notes

1 Abstract 231P_PR ‘Impact of the continuity of nursing care delivered by a pivot nurse in oncology on improving satisfaction and quality of life ofpatients with advanced lung cancer’: presented by Elie Kassouf during the Poster Display session on Thursday, 12 April, 12:30 to 13:00 (CEST) in Hall 1.
Journal of Thoracic Oncology, Volume 13, Issue 4, Supplement, April 2018.

2 Strutkowski, M, Saucier, A, Eades, M, Swidzinski, M, Ritchie, J, Marchionni, C, & Ladouceur, M (2008). Impact of a pivot nurse in oncology on patients with lung or breast cancer: Symptom distress, fatigue, quality of life, and use of healthcare resources. Oncology Nursing Forum, 35: 948– 954.
3 Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001 Jan-Feb;10(1): 19-28.

4 Wagner, EH, Ludman, EJ, Aiello Bowles, EJ, Penfold, R, Reid, RJ, Rutter, CM et al. (2014). Nurse navigators in early cancer care: A randomized, controlled trial. Journal of Clinical Oncology, 32(1): 12-19


Abstract 231P_PR - Impact of the continuity of nursing care delivered by a pivot nurse in oncology on improving satisfaction and quality of life of patients with advanced lung cancer

E. Kassouf1, M. Tehfe2, M. Floresci2, N. Blais2
1Centre Hospitalier Régional de Lanaudière, St-Charles-Borromée, QC, Canada, 2Notre Dame du CHUM, Montreal, QC, Canada

Background: Health care organizations around the globe have been implementing different strategies aimed at improving their care systems to obtain better patient- physician interaction and resolve underlying issues leading to patient dissatisfaction. In an effort to improve continuity of care inside a network of interdisciplinary teams, the Ministry of Health and Social Services of Québec has implemented the recruitment of pivot nurses in oncology services.

Methods: This study was conducted at the Notre Dame university hospital in Montreal. Patients were selected from theoutpatient admissions’ list, three months after the start of their treatment, and divided into two cohorts: the continuity of care (CC) cohort, where patients were followed by a PNO, and the usual care (UC) cohort, who received standard care from the oncology clinic staff. Participants in both groups completed the Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire (PMH/PSQ-MD), the FACT-L Scale for quality of life assessment and questions evaluating the understanding of their health status and disease. Another ten questions were adressed specifically to the CC in regards to nursing care and the health care system in Quebec.

Results: In total, 65 patients were recruited, 82% of whom were assigned to the CC cohort. Analysis of the PMH PSQ- MD questionnaire demonstrated superior outcomes in regards to information exchange, empathy, and quality of life for the CC cohort (p<.001). The FACT-L questionnaire also favored the CC cohort in terms of physical well being, social and family well being, emotional well being, and functional well being. These differences were highly significant and translated into better satisfaction when comparing the total score of the CC cohort to the UC cohort (p<.0001). Other variables examined revealed an adequate fulfilment of the PNO role as regarded by the participants, except for matters of an intimate nature.

Conclusions: The PNO appears to have a substantial role in the care of patients with advanced lung cancer. Continuityof care seems to improve patients’ quality of life and satisfaction by reducing the symptom strain experienced in the ambulatory patients.