Abstract 673P
Background
Approximately 2.59% of patients with non-small-cell lung cancer (NSCLC) harbor ROS1 fusion in China, while the latest status of diagnosis and treatment for them remains unclear.
Methods
The cross-sectional survey was conducted in 31 provinces in China. It planned to enroll 53 clinicians and 10 patients for qualitative survey, 262 clinicians and 101 patients for quantitative survey. Eligible clinicians had treated at least 5 NSCLC patients within the last 6 months, and patients were diagnosed with ROS1 fusion NSCLC. This report only presents the preliminary findings from the clinicians.
Results
From October 2023 to June 2024, 153 clinicians from 54 cities were involved in this survey. The ROS1 fusion gene testing recommendation rate in squamous and adenocarcinoma was 60.8% and 100%, respectively. However, only 59.0% of clinicians believed the actual testing rate of adenocarcinoma exceeded 90%. The main reasons for not accepting gene test were financial factors (81.0%) and low treatment willingness (45.1%). PCR (66.7%) and NGS (67.3%) were the main methods, 68.6% of clinicians conducted in-hospital testing routinely, while the out-of-hospital testing rate was significantly higher in hospitals in third-tier cities (p =0.004). 93.5% of clinicians preferred targeted therapy as the first-line treatment, with crizotinib the most frequently used (97.2%), followed by entrectinib (33.6%). For second-line therapy, 44.4% of clinicians recommended primarily chemotherapy (98.5%) as non- targeted therapy, while 33.3% opt for targeted therapy, with entrectinib (74.5%) used most. Clinicians in third-tier cities were less likely to prescribe targeted drug (p =0.004) as second-line therapy. Gastrointestinal reactions (85.0%) and liver or kidney function abnormalities (77.0%) were the most common adverse reactions. Only 5.0% of clinicians believed that the overall survival of patients with ROS1 fusion NSCLC could exceed 5 years.
Conclusions
We find that the actual rate of gene testing and in-hospital testing is relatively low and options for second-line targeted therapies are limited. There is an imbalance across hospitals in different tiers of city. 5-year survival rate of ROS1 NSCLC patients needs further improvement.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This survey was funded by Pfizer.
Disclosure
All authors have declared no conflicts of interest.