558P - Treatment duration and adherence of brigatinib as second-line treatment after crizotinib for ALK+ NSCLC in South Korea

Background

In Asian populations, there is a lack of substantial real-world data for brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor for patients with NSCLC. The aim of this study was to analyze real-world brigatinib treatment outcomes and dosing patterns in patients with ALK+ NSCLC who had received prior crizotinib in South Korea.

Methods

This retrospective, non-interventional cohort study used Health Insurance and Review Assessment claims data. The study included patients (>20 years old) who initiated brigatinib from 19 April 2019 to 31 March 2021 and who received crizotinib before brigatinib. We assessed patients' characteristics, treatment discontinuation, dose reduction, overall survival (OS) and adherence. Time to treatment discontinuation (TTD), time to dose reduction and OS were analyzed using Kaplan-Meier estimates. Patients whose proportion of days covered (PDC) was ≥0.8 were defined as treatment adherent.

Results

A total of 174 crizotinib-refractory patients (56.9% male; 27.1% brain metastasis history) with ALK+ NSCLC were included in the analysis (median [range] follow-up: 18 [0–34] months); the median treatment duration of prior crizotinib was 17 months. For brigatinib as second-line treatment, the median TTD was 25 months (95% CI:15.2–NE). 1- and 2-year treatment continuation rates were 63.2% and 51.5%, respectively. Median OS was not reached during the study period. The 2-year OS rate was 68.7%. 88.5% of patients reached full-dose brigatinib (180 mg/day) during treatment duration. The probability of continuing brigatinib at full dose (180 mg/day) or at peak dose (<180 mg/day) was 79.7% and 75.6% at 1 and 2 years, respectively. Overall, 93.1% of patients were adherent to brigatinib during treatment. The median PDC of brigatinib treatment was 0.98.

Conclusions

This is the first nationwide, real-world study of brigatinib treatment in a large cohort of crizotinib-refractory ALK+ NSCLC patients in South Korea. In this study, brigatinib demonstrated a longer treatment duration than in published clinical trials, as well as a favorable 2-year OS rate and high adherence. Second-line brigatinib treatment is of benefit in a real-world setting in South Korea.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Takeda.

Funding

Takeda.

Disclosure

J.H. Nam, S.H. Kwon: Financial Interests, Personal and Institutional, Research Grant: Takeda. B. Kim, S. Ha: Financial Interests, Personal, Full or part-time Employment: Takeda. All other authors have declared no conflicts of interest.