463P - Real-world treatment patterns for advanced EGFR wild-type NSCLC in second or third line in a large US database

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Non-Small-Cell Lung Cancer, Metastatic
Presenter Yulin Li
Citation Annals of Oncology (2016) 27 (suppl_9): ix139-ix156. 10.1093/annonc/mdw594
Authors Y. Li1, T. Pattipaka2, Y. Chia3, R. Walls4, G. Hooper5, M. Taylor3
  • 1Real World Data Science, F. Hoffmann-La Roche, 100020 - Beijing/CN
  • 2Real World Data Science-product Development, F. Hoffmann-La Roche, CH-4070 - Basel/CH
  • 3Real World Data Science, Genentech Inc., CA 94080 - San Francisco/US
  • 4Pdbr, F. Hoffmann-La Roche, CH-4070 - Basel/CH
  • 5Pharmaceutical Development Oncology, Roche Products Limited, AL7 1TW - Welwyn Garden City/GB



Although many studies have reported treatment patterns for advanced NSCLC, some patient and biomarker subgroups are not well described. We describe the real-world treatment patterns, with particular focus on erlotinib, following first-line therapy for advanced NSCLC patients in the US with EGFR wild-type tumors.


A retrospective analysis was conducted using the US Flatiron oncology database. Adult patients with stage IIIB/IV NSCLC or who developed advanced disease, with either documented EGFR wild-type or without recorded EGFR genotype, and who had received second-line (2L) or further-line (3L+) therapy between 1 January, 2013 and 31 January, 2016 were included. Patient demographic and clinical characteristics were described and assessed by the most frequently used drugs.


Overall, 3822 patients received 2L therapy with no EGFR activating mutation (2451 [64%] were confirmed as EGFR wild-type, 1371 [36%] had no EGFR test). Median age was 67.0 years; 54% were male; 65% were Caucasian; 87% were current/former smokers; 71% had non-squamous histology and 40% later received 3L therapy. Among patients with EGFR wild-type NSCLC, the most common 2L agent (monotherapy/combination) was pemetrexed (29.9%), followed by docetaxel (17.6%), paclitaxel (16.2%), nivolumab (13.3%), gemcitabine (10.6%), or erlotinib (8.1%). Erlotinib-treated patients were slightly older than those who received docetaxel, paclitaxel or pemetrexed (median age: 68 vs. 65, 66 and 66 years, respectively). Prescribing differed by histology in 2L and 3L, with gemcitabine and nivolumab more common in squamous-cell carcinoma (SCC) and docetaxel and pemetrexed in non-SCC. For EGFR wild-type NSCLC, erlotinib (12% vs. 8%) and gemcitabine (22% vs 11%) were more common in 3L than 2L, while pemetrexed (12% vs. 30%) was more common in 2L. Overall survival data and time to next treatment are being analyzed.


Several treatments were used as 2L or 3L therapy for patients with EGFR wild-type NSCLC. Evaluation of a real-world database indicates the importance of having multiple treatment options, where drug selection appears to be influenced by a number of factors, including age and histology.

Clinical trial indentification

Legal entity responsible for the study

F.Hoffmann-La Roche


F.Hoffmann-La Roche


Y. Li: Corporate-sponsored research (employee of Roche). T. Pattipaka: Corporate-sponsored research (employee of F. Hoffmann-La Roche AG). Y. Chia: Stock ownership (RLT); employee of Genentech. R. Walls: Employee of Roche; I have options in the Roche CONNECT employee share ownership scheme. G. Hooper: Employee of Roche Products Ltd. M. Taylor: Stock ownership (Roche); Employee of Genentech, A Member of the Roche Group