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319 Background: In the United States, the incidence of HCC has increased from 1.6 per 100,000 in 1975 to 4.9 per 100,000 in 2005. Care for HCC patients remains specialized and complex with transplant and surgery offering the only potential for long survival. However no comparative effectiveness of various treatment modalities across various stages of HCC exists. Methods: Medicare enrollees, older than 65 with an initial diagnosis of primary HCC between 2000-2007 were followed up through the end of 2009. For patients with stages I, II, III, and unstaged, data were obtained from the SEER and linked Medicare databases, with claims generated from Medicare parts A and B. Multivariate Cox proportional hazards models were used to assess overall and HCC related mortality in relation to receipt of various/no treatments, adjusting for concomitant therapies, demographics, general health status (Charlson comorbidity index), and liver conditions, moderate-severe liver disease. Results: Distributions across stages: males 64-71%, Caucasians 72-77%, African Americans 8-10%, Hispanics 12-14%; a majority (72-75%) was age 65-84; Hepatitis C was the most prevalent (17-41%). Conclusions: Compared to untreated patients, improved all-cause and HCC-related mortality was observed in all stages in the following order: transplant, surgical resection, liver directed therapy, and chemotherapy. Greater impact on HHC-related mortality was seen across all treatment groups. [Table: see text]

e14638 Background: Multispecialty care has increased for many cancers yet little evidence exists for hepatocellular carcinoma (HCC). Methods: Medicare non-transplant patients with HCC 1ry diagnosis in 2000-07 were studied using SEER-Medicare data with HCC claims generated from Medicare parts A-B, including patients with >=1 claims for HCC-related physician visits post-diagnosis. Physician specialties were grouped as Gastroenterology (GE), General/Family/Geriatric/Internal (GF), Diagnostic/Intervention radiology (DIR), Hematology/Medical oncology (HMO), General surgery/Surgery oncology (GSO), Radiation oncology (RO), Multispecialty clinic/group practice (MG), or Others. Visits by specialty seen within 4 weeks, and trends, were explored by comparing distributions, using t-tests, of visits by specialty, from the 2000/01 diagnosis cohort and the 2006/07 cohort. Results: Out of 2284 HCC patients diagnosed in 2000/01, 1380 (60%) had at least one HCC-related physician visit post-diagnosis, and 1330 (58%) within 4 weeks. Excluding the “Others” category, 1015 (44%) visited within 4 weeks. Of 3155 patients diagnosed in 2006/07, 1782 (56%) had any HCC-related visit, 1689 (54%) within 4 weeks, and 1295 (41%) when excluding Others. Among patients with at least one post-diagnosis HCC-related visit ever, the percentage of patients who saw only 1 type of specialist within 4 weeks of diagnosis did not change (44% in 2000/01 vs. 43% in 2006/07; p=0.15); nor did the percentage visiting multiple specialists (52% vs. 53%; p=0.58). The percentage of patients visiting GE within 4 weeks went from 27% to 25% (p=.10), 11% to 10% (p=.41) for GF, 28% to 31% (p=.08) for HMO, 4% to 3% (p=.53) for RO, 65% to 67% (p=.33) for Others, and remained at 23% for DIR, 16% for GSO, and 1% for MG. Among patients who saw only 1 type of specialist within 4 weeks of diagnosis, the percentage visiting GE went from 14% to 12% (p=.29), 4% to 5% (p=.50) for GF, 11% to 10% (p=.55) for DIR, 11% to 12% (p=.36) for HMO, 4% to 3% for RO, 52% to 53% for Others, and remained at 5% for GSO, and

7101 Background: Limited data exist on real-world treatment patterns, healthcare utilization, and associated costs of advanced SCLC among elderly patients in the US, and there are no recent comparisons between patients with advanced SCLC and advanced NSCLC. Methods: We retrospectively analyzed administrative claims data for elderly patients (≥65 years) from the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database for 2000-2008. Patients with a new diagnosis of distant stage lung cancer receiving cancer-directed therapy (ie, surgery, radiation, biologics, and/or chemotherapy) were grouped by tumor type (SCLC [n=5,855] vs NSCLC [n=24,090]). Survival was compared using Kaplan-Meier Log-rank; categorical measures with Chi-square statistics; and continuous measures with t-tests. Results: Compared to SCLC patients, a significantly greater proportion of patients with NSCLC received radiation therapy (75.6% vs 65.4%; p

6131 Background: Clinical trials have demonstrated that CT improves survival and quality of life in pts with AdvNSCLC. Our prior studies suggest that only 26% of older pts diagnosed with AdvNSCLC received CT through 2002. In this study, we examined more recent patterns, and the effect of socio-demographics, race, and age on receipt of CT in older pts with AdvNSCLC. Methods: Medicare pts diagnosed with AdvNSCLC from 2001-2005 were identified in SEER registries. Medicare enrollment data provided demographic information (age, race, sex, marital status), augmented with census tract level data on median household income. Comorbid conditions at baseline were identified by ICD9-CM diagnoses on claims. Receipt of 1st line CT was identified based on agent-specific procedure codes in claims. Logistic regression examined predictors of 1st line CT. Results: Of 31,341 pts with Adv NSCLC, 34% received 1st line CT. As reflected in the table, poor predicted PS (PredPS), multiple medical comorbidities, and black race were associated with lower likelihood of CT receipt. Being female, married, having higher income, and being diagnosed at a later year were associated with a higher likelihood of receiving CT. Conclusions: Even when controlling for factors such as PS, our results suggest the presence of age, race, and socio-economic disparities in the receipt of 1st line CT for older patients with AdvNSCLC. [Table: see text]

e15146 Background: BM is diagnosed in 70-80% of men with metastatic PCa. Less is known about the timing of BM diagnosis following incident non-metastatic PCa and associated patient characteristics. In this study, we determined the incidence and timing of post-diagnosis BM (BMpd) among PCa patients (pts) by incident stage, age, race and year of diagnosis using a large observational dataset. Methods: We analyzed pts aged 66 or older from the linked Surveillance, Epidemiology, and End Results and Medicare (SEER-Medicare) database. Pts with PCa were identified between 2000 and 2007 and were followed until death, Medicare disenrollment, HMO enrollment, or end of the study (December 31, 2009). The cohort included incident stage III and IV(M0) PCa in SEER, and identified BM occurring either within (i.e., +/-) 1 month of the SEER diagnosis month (BM90) or beyond the initial 90-day window (BMgt90) based on the presence of at least one inpatient or one outpatient claim with a diagnosis code of 198.5. We calculated summary and chi-square statistics to examine BMpd, BM90, and BMgt90 by incident stage, age, race and year of PCa diagnosis. Results: Among 9,188 Stage III (72%) and IV(M0) (28%) PCa pts who met inclusion/exclusion criteria, 14.6% (n=1,345) had BMpd: 2.3% (n= 217) had BM90 and 12.3% (n=1,128) had BMgt90. Average age was 72 years and 9% were African American (AA). Incidence of BMpd varied by stage (stage III: 11%; stage IV/M0: 25%; p85 years: 22%; p85 years: 5% and 17%; p

e15148 Background: There is questionable reliability of administrative claims data to identify BM, yet historically such claims were the only source for identifying BM in SEER-Medicare (SM). Starting in 2004, SEER provided tumor registry information on incident BM. We compared frequencies of BM using registry and claims data among men diagnosed with PCa. Methods: We analyzed pts aged 66 and older from the linked SM database. Pts with stage IV (M1) PCa diagnosed between 2004 and 2007 were followed until death or censoring. Identifying pts with BM using claims required at least one inpatient or outpatient claim with a diagnosis code of 198.5 within (i.e., +/-) 1 month of the SEER diagnosis month (designated BMclaims-90) or at any time during follow up (designated BMclaims-ever). BM identified using SEER was based on an indicator for bone metastasis at diagnosis using the AJCC M1b classification (designated BMseer). We calculated the sensitivity and specificity of BM at diagnosis in claims (BMclaims-90) with respect to the incident BM data in SEER, assuming BMseer to be the gold standard. Results: Application of inclusion/exclusion criteria resulted in 3,664 stage IV (M1) PCa pts. Average age was 79 years, 13% were African American, and 61% had poorly/un-differentiated tumors. BMseer (n=2,301; 63%) was higher than BMclaims-90 (n=1,979; 54%) and lower than BMclaims-ever (n=2,878; 79%). Assuming BMseer as the standard measure of BM at diagnosis, BMclaims-90 had 58.8% sensitivity (n=1,353), 54.1% specificity (n=737), and 68.4% positive predictive value for identifying BM at diagnosis. Among men with BM identified using BMseer, 84% (1,931) had BMclaims-ever and the median (min; max; average) time to the first BM claim was 0.9 (-2.6; 57.1; 3.9) months. Among men with BM identified using BMclaims-90, the median (min; max; average) time to the first BM claim was 0.6 (-1.0; 2.0; 0.7) months. Conclusions: The incidence of BM in PCa pts differs between a commonly-used algorithm to identify BM in claims data and the AJCC staging information in tumor registry data. There was moderate concordance between the claims-based measure and the SEER-based measure of BM at diagnosis.

e14522 Background: Multiple treatment options for HCC exist and the treatment(s) received depend on clinical characteristics, resource availability and access to specialists. Their comparative cost effectiveness is unclear. Methods: Medicare patients with a 1st diagnosis of 1ry HCC in 2000-07 were studied through end of ‘09. Data are from the SEER with linked Medicare parts A-B. We use incremental cost effectiveness ratios (ICERs) and 95% cost intervals for transarterial chemoembolization (TACE) vs no treatment, liver transplantation (OLT), surgical resection (RS), radiofrequency ablation (AB), systemic chemotherapy (CH), and radiation therapy (RD). Using HCC-related mortality, Cox proportional hazards models were used to compute mean life years survived (LY) under each modality, adjusting for clinical (cancer stage, underlying health status, liver conditions) and demographics. Multiple propensity scores were incorporated to adjust for treatment selection bias. Average HCC-related Medicare costs (US$2011) attributed to each modality are estimated using generalized least squares methods. Results: Cancer stages 1, 2, 3, and 4 represent 24%, 9%, 14%, and 17% of the 11,047 patients: 37% unstaged, 66% male, 75% Caucasian, 10% African American, and 13% Hispanic, 61% of patients untreated, 8% TACE, 2% “liver directed therapy” (LD), 4% OLT, 8% RS, 5% AB, 8% CH, and 6% RDST. Relative to no treatment, OLT was most effective in reducing HCC mortality (HR .06, p

5539 Background: Head and neck squamous cell carcinoma (HNSCC) is predominantly a disease of the elderly, however age and co-morbidity may affect therapy decisions. The purpose of this study was to assess the patterns of care of elderly HNSCC patients and identify factors associated with non-receipt of surgery and chemoradiation (CRT). Methods: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database (1992-2007) we identified a retrospective cohort of non-metastatic HNSCC patients and categorized them into treatment cohorts. Comparisons were made between surgery vs. non-surgery, and CRT vs. non-CRT cohorts. Multivariate logistic regression models examined factors associated with non-receipt of treatment. Variables included tumor location, stage, year of diagnosis, age, gender, marital status, race, comorbidity, race-comorbidity interaction, SEER region, socioeconomic variables, and hospital affiliations. Results: The final cohort of 11,336 were 63% male and 83% white. 52% had no co-morbidities, 44% had oral cavity HNSCC, 52% were diagnosed between 2002 and 2007, 58% had surgery, and 21% received CRT. For the CRT vs. non-CRT model, increasing age (OR = 0.93; 95% CI 0.92 -0.94) and non-whites with co-morbidity (OR = 0.71; 95% CI 0.55 – 0.92) were associated with decreased likelihood of receiving CRT. More advanced staged disease, oropharyngeal tumor location, and diagnosis after 2002 were associated with increased likelihood of receiving CRT. For the surgery versus non-surgery model, age was not associated with receipt of surgery (OR 0.99; 95% CI 0.99-1.00), nor was existence of comorbidity in white patients (OR 0.97; 95% CI 0.88-1.05). However, recent year of diagnosis, non-oral cavity tumor location, and advanced stage were all associated with reduced likelihood of receiving surgery. During the 15 year surveillance period, patients were less likely to receive surgery, and CRT was used more often. Conclusions: Age may influence the non-receipt of CRT in this elderly cohort but does not appear to be significantly associated with the non-receipt of surgery. There has been an increasing trend in the receipt of CRT with a decrease in surgery over the past 15 years.

e14550 Background: Octreotide LAR is used for treatment of hormonal syndromes associated with NETs and may delay tumor progression. Although various dosages and schedules of administration have been reported, a systematic analysis has not been performed. Methods: Using the SEER-Medicare database, we identified patients diagnosed with NETs between July 1999 and December 2007. We then excluded those patients with poorly differentiated histology, under age 65 at diagnosis, enrolled in HMOs, and who did not have continuous Part A & B enrollment between NET diagnosis and the end of 12 months after the initial octreotide LAR use. HCPCS codes, J2352 and J2353, were used to identify octreotide LAR from Medicare claims. For each patient, mean octreotide LAR dose per month was calculated and classified into five dosing categories, ≤ 10, 11-20, 21-30, 31-40, >40 mg, for the initial 3 months and every subsequent 3 months during the first year. Results: A total of 3,543 octreotide LAR treatments were observed among 355 patients during their first year of therapy. Dose given on a single day ranged from 10 mg to 90 mg. 86 (24.2%) patients required a ≥ 30% escalation in dose during the first year of therapy. The distributions of the mean monthly doses by dosing categories for the initial 3 months and the highest use 3 months during the first year are included in the Table below. 134 (37.7%) patients required doses greater than 30 mg per month. Conclusions: Our analyses showed that patients frequently required the escalation of octreotide LAR dose during their course of illness. A substantial number of patients required doses greater than the FDA approved dose of 30 mg per month. [Table: see text]

118 Background: The use of intensity modulated radiotherapy (IMRT) for the treatment of prostate cancer (CaP) has been widely promoted due to the hypothesized benefit of low late toxicity. Methods: The SEER-Medicare database was queried for CaP patients treated with external beam radiotherapy (EBRT), 1991-2007. CPT billing codes were used to identify patients treated with IMRT or standard EBRT (sEBRT), which was comprised of conformal radiotherapy or a four-field technique. Patients without a treatment billing code were excluded from the analysis. Information on dose is unavailable. CPT codes were also used to identify procedures associated with gastrointestinal (GI) or genitourinary (GU) toxicity related treatments. Cumulative incidence rates for GI and GU toxicity were calculated with death treated as a competing event. Results: A total of 137,427 patients who were 65 years or older at the time of CaP diagnosis and who had CaP as their only cancer diagnosis were retrieved from the SEER-Medicare database: 60,806 were treated with EBRT and a treatment billing code was identified for 35,388 patients. No patient received combined therapy. Seventeen percent of patients received IMRT. The median follow-up for patients receiving IMRT is 40 months (mo) (range 2-157) vs 77 mo (range 0-203) for patients receiving sEBRT. Overall, 3,699 (10%) patients experienced a toxicity requiring an intervention. The five year rate of GI The gastrointestinal (GI) and genitourinary (GU) toxicity comparisons are listed in the table. For both endpoints, rate of toxicity at five years was higher for the IMRT group. The most common GU toxicity for both groups was dilation of a urethral stricture (3.8% of all sEBRT patients vs 3.4 of all IMRT patients). Cauterization of rectal bleeding was the most common GI toxicity (2.4% of all sEBRT patients vs 1.6 of all IMRT patients). Conclusions: While the rates of GI toxicity between IMRT and sEBRT are comparable, of concern is the higher rate of GU toxicity for the IMRT patients despite this group having a shorter follow up than the sEBRT group. [Table: see text]

214 Background: We explore various treatments at all stages of Hepatocellular Carcinoma (HCC), in a SEER (Surveillance, Epidemiology and End-Results Program) Medicare population and assess their impact on HCC-specific and overall survival. Methods: Medicare enrollees, older than 65, with an initial diagnosis of a primary HCC between 2000-07 were followed up through end of 2009. Data are from the SEER and linked Medicare databases, with claims generated from Medicare parts A and B. Using multivariate Cox-proportional hazards models, we assessed overall and HCC-related mortality in relation to receipt of treatment/no treatment, adjusting for demographics, general health status (CCI), cancer stage and liver conditions. Results: Out of the 9054 HCC patients, older than 65, who did not get a liver transplant, 76% were Caucasian, 8% African American (AA), 63% male, and 37% got treatment [12% transarterial chemoembolization (TACE), 12% systemic chemotherapy, 1.5% selective internal radiation therapy (SIRT), 9% external beam radiation therapy (EBRT), 8% surgical resection and 9% ablative therapy]. Treatment was associated with a reduction of overall (HR=0.35, P= 1) had higher mortality (1.27, Conclusions: In HCC SEER Medicare patients, all treatments except SIRT were associated with a significant reduction in HCC related mortality. A limitation of this study is that, through the data, we cannot accurately depict the severity of the disease.

210 Background: We examine treatment patterns and associated survival outcomes of TACE at all stages of Hepatocellular Carcinoma in SEER Medicare. Methods: Medicare enrollees, 65 and older, with a diagnosis of a primary HCC between 2000-07 who received treatment were followed through end of 2009 using the Surveillance, Epidemiology and End-Results Program (SEER) and linked Medicare databases, with claims from Medicare parts A and B. Using Cox proportional hazards models, we assessed the impact on mortality, of each additional TACE, systemic chemotherapy, SIRT, external beam radiation therapy, ablation and surgical resection, controlling for cancer stage, general health status, underlying liver disease (alcohol related, Hepatitis B and C, moderate/severe liver dysfunction), and demographics. We assessed overall and HCC-related mortality for all, then for TACE-only treated patients, and stratified outcomes by stage. Results: Out of 3322 treated non-transplant HCC patients, 1094 got TACE, 74% were Caucasian, 6% African American, 66% male, and 45% were at stage 1/2, 17% at stage 3 and 14% at stage 4. Most (56%) received 1, 23% 2, 11% 3 and 10% 4 or more TACEs. In the adjusted models, both overall and HCC mortality reduction were associated with treatment with up to 2 TACEs (HR=0.68, P= Conclusions: TACE provides a survival benefit for elderly HCC patients in clinical practice. However, the survival benefit may decrease beyond 3 TACE treatments and varies by stage. Additional TACE treatments may be confounded if 4+ TACE treatments are utilized mainly to treat biologically aggressive disease related to extensive tumor burden, advanced disease or recurrences. Treatment selection bias cannot be excluded and should be further explored.

150 Background: To use SEER-Medicare data to evaluate treatment (tx) patterns and health care costs in U.S. women with metastatic breast cancer (MBC). Methods: Key inclusion criteria included women diagnosed (dx) with breast cancer in 2001-2005 with 1) enrollment in Medicare 12 mo prior to dx through follow-up (2008) or death; 2) initial dx of “distant” disease or 2 indications of secondary malignancy >2 mo after initial dx; and 3) indication of tx with injectable hormonal, chemotherapy (chemo) or targeted/biologic therapies. Lines of tx were designated as: 1st-line if 1st agent (or agents, if on same day) after dx of MBC; new agents administered > 42 d after the previous agent are a new line, as well as an agent administered > 60 d after last dose of the same agent. Oral medication data were not available. Kaplan-Meier techniques estimated lifetime total health costs by partitioning data into 30-d intervals starting with MBC dx date and then summing the product of mean cost in each interval by the probability of survival to the start of the interval. Bootstrapping methods were used to generate 95% confidence intervals (CI). Results: The table lists the top 5 injectable tx for first, second, and third line, with associated mean lifetime costs. Conclusions: In this population, the injectable fulvestrant was the most commonly used first-line tx, with vinorelbine most frequently used in second- and third-line settings for MBC. Mean lifetime cost of MBC was $110,000. [Table: see text]

Introduction Black patients have lower bladder cancer survival rates than White patients, but previous studies have not been able to explain this difference. Recent work has found that racial disparities in bladder cancer survival persist after adjusting for sex, age, and tumour characteristics. The objective of this study was to assess the association of insurance status, comorbidities, marital status, the receipt of radical cystectomy and being qualified for federal assistance (a marker for low individual-level SES) with disparities in bladder cancer survival. Methods We identified 15 666 (592 Black and 15 074 White) bladder cancer cases diagnosed between 1992 and 1999 (follow-up through 2003) from the SEER-Medicare database, and constructed relative survival models to assess 5-year survival disparities. Results The relative survival ratios (RSR) for Black patients vs White patients were as follows: unadjusted, RSR 2.22 (95% CI 1.90 to 2.59), adjusting for year of diagnosis, registry, age, sex, stage, and grade, RSR 1.54 (95% CI 1.32 to 1.81); additionally adjusting for comorbidity score, marital status, and receipt of radical cystectomy, RSR 1.45 (95% CI 1.25 to 1.70); additionally adjusting for SES, RSR 1.26 (95% CI 1.08 to 1.48). Lower comorbidity score, being married, higher SES and receipt of radical cystectomy were independently associated with increased bladder cancer survival. Conclusions Racial disparities persist after adjusting for comorbidity score, marital status, receipt of radical cystectomy and SES in this insured population. As the SES variable used in this study does not capture the diversity across the SES gradient and it is strongly associated with race, further studies investigating the influence of SES and its correlates may provide further explication of this disparity.

7083 Background: The benefit of chemotherapy for elderly patients with SCLC in the community setting has not been quantified. The purpose of this retrospective cohort study is to analyze factors as...

e15117 Background: Management of advanced-stage PCa frequently requires multimodal therapy and there is a hypothesized benefit of consulting with multiple specialists prior to commencing active tre...

e18500 Background: Combination of chemotherapy and the B-lymphocyte specific antibody rituximab improves overall survival in both diffuse large B-cell lymphoma and follicular lymphoma. However, so ...

6085 Background: Observational studies analyzing cancer treatment and outcomes in datasets such as Surveillance, Epidemiology and End Results (SEER)-Medicare are unable to capture performance statu...

7014 Background: Cisplatin (Cis)-based ACT has shown an overall survival (OS) benefit in Randomized Controlled Trials (RCTs) for stage II-IIIA NSCLC and become the “standard” therapy. However, elde...

6001 Background: Breast cancer (BrCa) is responsible for the largest share of cancer-related spending in the US. While the cost of cancer care is substantial and increasing yearly, little is known ...

Introduction: Older patients with pancreatic cancer are often not offered pancreaticoduodenectomy (PD) due to potentially high perioperative risk and prolonged post-operative recovery. These patients may have undetected vulnerabilitities related to frailty that may adversely affect surgical outcomes. Methods: PD-eligible patient over 50 were enrolled onto this IRB-approved prospective observational study. Extensive perioperative clinical information including Vulnerable Elder Survey (VES-13), short physical performance battery (SPPB), and Fried's Criteria for frailty were collected. Complications were prospectively recorded and graded according to established guidelines (Clavien scores). Quality of life (QoL) measures were taken at baseline and at 1, 3, and 6-months post-PD. Results: Seventyeight patients were enrolled from 10/1/2007-9/1/2010: 53 had a PD (median age 68 years;range 46-85) and 25 were inoperable or declined PD. Significant preoperative vulnerability was identified in resected patients; VES-13 >3 in 24%; SPPB

G A A b st ra ct s (95% CI: 15.3-16.5) in 1993-1997 to 18.3 (95%CI: 17.8-18.9) in 2003-2007. On the other hand, a 32% decrease was observed in ages >50 from 120.0 (95% CI: 119.1-121.8) in 1993-1997 to 90.6 (95% CI: 89.6-91.7) in 2003-2007. Hispanic men had 27% higher CRC rates than Hispanic women, but the age and time trends were similar for men and women. The overall stage distribution was 33% localized, 42% regional, and 25% distant in ages 50. Over time, the proportion of cases with regional and distant disease increased by 37% and 18% in ages 50. The Poisson regression model confirmed the increasing CRC incidence in younger Hispanics during 1993-2007. The 1-year observed and relative survival “improved” in all ages from approximately 86% to 90%, however no significant improvement in 5-year observed or relative survival was observed in patients

520 Background: Over the last decade, the treatment of metastatic colorectal cancer (mCRC) has changed dramatically as new drugs and hepatic resection have been incorporated into practice. The goal of this study is to examine treatment patterns and survival trends for older patients (pts) with mCRC. Methods: Pts ≥ age 65 with mCRC diagnosed (dx) 2001-2005 were identified from the SEER-Medicare database. Pts were excluded for lack of Medicare parts A and B in the year prior to dx, second malignancy, or non- adenocarcinoma histology. First-line (1L) chemotherapy (CTx) use was identified by claims within 3 months of dx. Metastatectomy was identified by various claims for liver resection. Comorbidity was assessed by Klabunde index. A Cox proportional hazards regression model was used to assess the effect of demographic and treatment factors on survival. Results: A total of 5,725 pts (median age 77) met inclusion criteria. 274 pts (5%) underwent hepatic resection and 2,647 (46%) received CTx. From 2001-2003, 43% of pts received 1L CTx (34% and 1% with regimens containing irinotecan (Iri) and oxaliplatin (Ox) and 49% with 5-FU/cap alone). From 2004-2005, 51% of pts received 1L CTx (25%, 14%, and 37% with regimens containing bevacizumab (Bv), Iri, and Ox and 40% with 5-FU/cap alone). In the multivariate analysis using the Cox proportional hazards model, survival was significantly improved in pts receiving CTx or hepatic resection and in pts dx 2004-2005 (Table). Conclusions: In an older mCRC population, hepatic resection, CTx use, and mCRC dx in 2004-2005 are associated with improved survival. Improved survival of pts dx in 2004-2005 coincides with the 2004 approval dates and uptake of Bv and Ox, and may be associated with the use of these therapies. Further analysis will examine the associations between specific Ctx regimens, Bv, and survival and will include pts dx through 2007. [Table: see text] [Table: see text]

4658 Background: To date, docetaxel (D) is the only chemotherapy agent that has provided a survival benefit to metastatic castration resistant PCa patients (pts). The objective of this study was to...

4655 Background: Disparities in access to health care across demographic groups have been widely documented for primary therapies of PCa and among patients (pts) with early-stage PCa. Less is known...

3613 Background: Clinical trials have demonstrated a survival benefit of oxaliplatin (OX)- or irinotecan (IRI)-based combination chemotherapy regimens for treatment of stage IV colon cancer patient...

1104 Background: The NCCN GLs are the standard of care for the treatment of women with metastatic breast cancer (mBC). The primary aim of the current project is to assess concordance between the NC...

7633 Background: Randomized clinical trials conducted in carefully selected patient populations have led to the approval of novel systemic agents for advanced NSCLC in the last decade. The impact o...

e16520 Background: Invasive lobular carcinoma (ILC) is increasingly recognized as having a biology distinct from the more common invasive ductal carcinoma (IDC). Series comparing ILC and IDC are of...

e15539 Background: Real world HRU in second-line aOC has not been well quantified. The objective of this study was to assess HRU and treatment patterns in women with previously-treated aOC subseque...

e16074 Background: The survival benefit of D in treatment of hormone refractory PC (HRPC) has been established in the TAX327 trial, but it is unclear how this benefit would translate in a heterogeneous population. This study sought to simulate the survival impact of D in a population of older pts with M1 PC on androgen deprivation therapy (ADT). Methods: A combination of TAX327 trial data and SEER-Medicare (SM) data were used. In pts age 69+ and randomized to D (every 3 weeks, D3P) or mitoxantrone (M), trial data showed a survival benefit for D. Accordingly, SM pts age 69+ diagnosed with M1 PC between 1994 and 2002 and receiving only ADT were selected. Graphical plots and statistical tests were used to find best-fitting parametric survival functions for D3P, M, and SM pts. The survival benefit for D was imposed on unadjusted and covariate-adjusted SM survival curves. The simulated benefit was assessed at 12 mos and 24 mos post-diagnosis of M1 PC in SM pts. Results: There were 326 TAX327 trial pts (D3P = 159, M = 167) used in the analysis. Median survival was 15.7 mos (12.6 - 19) in the M arm and 18.9 mos [17 - 21.8] in the D3P arm (p = 0.03). There were 3,515 SM pts, based on inclusion criteria. Median survival benefit of D was 3.2 mos based on Kaplan-Meier estimates and 2.4 mos using parametric curves in the TAX327 69+ group. Following covariate-adjustment in the SM sample, at 12 mos post-diagnosis, the median survival in mos was 61.7 (CI 36.3 - 87) in the ADT group and 62 (CI 37.6 - 87.1) in the simulated ADT+D group (i.e., 0.3 mos simulated benefit of D). A 0.8 mos simulated benefit was found if D was initiated 24 mos post diagnosis (in pts more likely to have HRPC). Conclusions: The survival benefit of docetaxel from the TAX327 trial is attenuated in a heterogeneous SEER-Medicare sample, and the simulated survival benefit is larger among patients who are more likely to have hormone refractory prostate cancer. [Table: see text]