Abstract 2864
Background
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are recommended as first-line treatment for EGFR mutation-positive NSCLC by international and Swedish clinical guidelines. However, knowledge on treatment patterns of TKIs in a real life clinical setting is limited. The aim was to describe disease characteristics and comorbidities of stage IIIB/IV NSCLC patients receiving first line TKI, and treatment patterns related to switch, re-challenge, and discontinuation.
Methods
All patients with stage IIIB/IV NSCLC during 2010-2015 were identified in the national Swedish Cancer Registry, and linked with data on dispensed EGFR-TKI drugs and comorbidity from Swedish national health registries. First line TKI treatment was defined from date of first dispensed EGFR-TKI drug (gefitinib, erlotinib, afatinib) until a treatment gap of minimum 90 days or switch to another EGFR-TKI drug within the same drug class.
Results
Of 9,992 stage IIIB/IV NSCLC patients (mean age 70 years, female 49%), 1419 (14%) received first-line TKI treatment. Overall, 59% of TKI treated patients (median age 68 years) were female, 44% had at least one comorbidity, 85% had adenocarcinoma, and 89% were stage IV. TKI treatment patterns changed during the observation period. Initiation of TKI treatment declined from 23% to 9% in 2010 and 2015, respectively. However, median time from diagnosis to treatment initiation was shorter (from 7 to 2 months) at the end of observation, and the median treatment length was prolonged particularly for patients diagnosed in later years (from about 2 to 6 months in 2013 and 2015, respectively). Switching and re-challenge patterns were more common at the end of the observation period.
Conclusions
This is the first large nationwide study on patients receiving first-line TKIs in routine clinical practice in Sweden. Changes in TKI treatment patterns, such as shorter time to treatment initiation, prolonged treatment length, and more TKI switching and re-challenging during the observation period, may reflect extension of EGFR testing. Correctly targeted patients according to clinical guidelines, may contribute to an extended survival of this patient population.
Clinical trial identification
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Editorial Acknowledgement
Disclosure
H. Nordahl Christensen: Employee: AstraZeneca. All other authors have declared no conflicts of interest.
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