573P - LUMINATE-103: Real-world treatment patterns and outcomes of patients (pts) with epidermal growth factor receptor mutant (EGFR MU), non-squamous (NSQ) locally advanced/metastatic non-small cell lung cancer (a/mNSCLC): Pooled analysis of large US electronic health record (EHR) datasets

Background

Several tyrosine kinase inhibitors (TKIs) targeting EGFR are approved for first-line (1L) treatment of EGFR MU NSCLC. Most pts progress on 1L EGFR TKIs and, unless they stay on current treatment or switch to other targeted therapy, will advance to receive systemic therapies. This study evaluated real-world treatment patterns and outcomes of pts with EGFR MU NSQ a/mNSCLC.

Methods

This retrospective observational study used pooled, de-identified EHR-derived data from US nationwide databases Flatiron Health, ConcertAI Patient360, and ConcertAI RWD360nlp. To exclude duplicate EHR, overlap assessment was performed via tokenization. EHR from pts diagnosed with EGFR MU NSQ a/mNSCLC between 2017–2022 who received earlier-line osimertinib (Osi), followed by 2L platinum-based chemotherapy, or 3L docetaxel (Doc) were included. Times from treatment line initiation until death (OS), within-line progression or death (PFS), treatment discontinuation (TTD), and initiation of next line or death (TTNTD) were assessed.

Results

Data from 256 pts were included: 227 (89%) in 2L and 29 (11%) in 3L. Median age at 2L/3L start was 67 (33–87) yr, 176 (69%) pts were female, 155 (61%) had ECOG PS of 0–1, and 225 (88%) had stage 3B or 4 NSCLC at diagnosis. Most common treatments were carboplatin + pemetrexed + pembrolizumab (39%) or carboplatin + pemetrexed (28%) in 2L, and Doc + ramucirumab (69%) or Doc mono (31%) in 3L. All 2L and 86% of 3L pts had received 1L Osi alone (2L: 68%; 3L: 52%) or Osi after older-generation EGFR TKI or a few rounds of chemotherapy ± IO (2L: 32%; 3L: 34%). Time-to-event outcomes are shown in the table. Table: 573P

Real-world clinical outcomes

2L, second-line; 3L, third-line; CI, confidence interval; NE, not estimable; OS, overall survival; PFS, progression-free survival; pts, patients; TTD, time to treatment discontinuation; TTNTD, time to next treatment or death.

Conclusions

RWE shows that 2L/3L treatment options for pts with EGFR MU NSQ a/mNSCLC are mostly limited to chemotherapy and are associated with poor outcomes, demonstrating a high unmet need for novel treatments.

Clinical trial identification

Editorial acknowledgement

Medical writing support was provided by Judith Land, PhD, from Aptitude Health, The Hague, the Netherlands.

Legal entity responsible for the study

AbbVie Inc.

Funding

AbbVie Inc.

Disclosure

B.C. Cho: Financial Interests, Personal, Other, Consulting role: Abion, BeiGene, Novartis, AstraZeneca, Boehringer Ingelheim, Roche, BMS, CJ, CureLogen, Cyrus therapeutics, Ono, Onegene Biotechnology, Yuhan, Pfizer, Eli Lilly, GI-Cell, Guardant, HK Inno-N, Imnewrun Biosciences Inc., Janssen, Takeda, MSD, Janssen; Financial Interests, Personal, Advisory Board: KANAPH Therapeutic Inc, Bridgebio therapeutics, Cyrus therapeutics, Guardant Health, Oscotec Inc; Financial Interests, Personal, Other, Advisory role: Medpacto, Blueprint medicines, RandBio, Hanmi; Financial Interests, Personal, Member of Board of Directors: Interpark Bio Convergence Corp., J INTS BIO; Financial Interests, Personal, Stocks/Shares: TheraCanVac Inc, Gencurix Inc, Bridgebio therapeutics, KANAPH Therapeutic Inc, Cyrus therapeutics, Interpark Bio Convergence Corp., J INTS BIO; Financial Interests, Personal, Royalties: Champions Oncology, Crown Bioscience, Imagen; Financial Interests, Institutional, Research Grant: MOGAM Institute, LG Chem, Oscotec, Interpark Bio Convergence Corp, GIInnovation, GI-Cell, Abion, AbbVie, AstraZeneca, Bayer, Blueprint Medicines, Boehringer Ingelheim, Champions Onoclogy, CJ bioscience, CJ Blossom Park, Cyrus, Dizal Pharma, Genexine., Janssen, Lilly, MSD, Novartis, Nuvalent, Oncternal, Ono, Regeneron, Dong-A ST, Bridgebio therapeutics, Yuhan, ImmuneOncia, Illumina, Kanaph therapeutics, Therapex, JINTSbio, Hanmi, CHA Bundang Medical Center; Other, Personal, Other, Founder: DAAN Biotherapeutics. Q. Xu, S. Ng, R. Kamalakar, V. Blot, H. Alhasani, S. Karve: Financial Interests, Personal, Full or part-time Employment: AbbVie Inc; Financial Interests, Personal, Stocks/Shares: AbbVie Inc. J.W. Goldman: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Advisory Board: Genentech, Eli Lilly, Janssen, AbbVie, Gritstone; Financial Interests, Institutional, Coordinating PI: AstraZeneca, Eli Lilly; Financial Interests, Institutional, Local PI: Genentech, Janssen, BMS, AbbVie. N. Girard: Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, MSD, Roche, Pfizer, Mirati, Amgen, Novartis, Sanofi, gilead; Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Roche, Pfizer, Janssen, Boehringer, Novartis, Sanofi, AbbVie, Amgen, Lilly, Grunenthal, Takeda, Owkin, Leo Pharma, Daiichi Sankyo, Ipsen; Financial Interests, Institutional, Research Grant, Local: Roche, Sivan, Janssen; Financial Interests, Institutional, Funding: BMS, Leo Pharma; Financial Interests, Institutional, Research Grant: MSD; Non-Financial Interests, Personal, Officer, International Thymic malignancy interest group, president: ITMIG; Other, Personal, Other, Family member is an employee: AstraZeneca. D. Planchard: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, Merck, Novartis, Pfizer, Roche, Samsung, Celgene, AbbVie, Daiichi Sankyo, Janssen, Seagen, Gilead, Pierre Fabre; Financial Interests, Personal, Invited Speaker: AstraZeneca, Novartis, Pfizer, priME Oncology, Peer CME, Samsung, AbbVie, Janssen; Non-Financial Interests, Personal, Principal Investigator, Institutional financial interests: AstraZeneca, BMS, Merck, Novartis, Pfizer, Roche, Daiichi Sankyo, Sanofi-Aventis, Pierre Fabre; Non-Financial Interests, Personal, Principal Investigator: AbbVie, Sanofi, Janssen. S. Baijal: Financial Interests, Personal, Other, Honoraria: AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Chugai, Daiichi Sankyo, FoundationOne, Gilead, GSK, Lilly, Merck Serono, Merck Sharp & Dohme, Novartis, Pierre Fabre, Pfizer, Roche, Servier, Sanofi, Takeda; Financial Interests, Personal, Officer, Honoraria: Bristol Myers Squibb, Janssen. S. Lu: Financial Interests, Institutional, Invited Speaker: Hansoh, AstraZeneca, Roche, Hengrui; Financial Interests, Institutional, Advisory Board: AdtraZeneca, Prizer, Boehringerlngelheim, Hutchison MediPharma, ZaiLab, GenomiCare, Yuhan Corporation, Menarini, InventisBio Co.Ltd, Roche, Simcere Zaiming Pharmaceutical Co., Ltd.; Financial Interests, Personal, Research Grant: AstraZeneca, Hutchison, BMS, Heng Rui, Roche, Hansoh, BeiGene, Lilly Suzhou Pharmaceutical Co.Ltd; Financial Interests, Personal, Coordinating PI: FibroGen.