1410P - Characterization of patients with advanced non-small-cell lung cancer (NSCLC) harboring KRASG12C mutation and their associated direct healthcare costs in Spanish routine clinical practice (SILK study)

Background

Around 15% of patients (pts) with NSCLC harbor the KRAS ^G12C mutation. In a changing landscape of KRAS ^G12C treatment (tx), there is a need for updated real-world evidence on characteristics and outcomes of routine clinical practice. Here we present characteristics, tx patterns, outcomes, and direct healthcare costs in pts with NSCLC and KRAS ^G12C in the Spanish clinical practice.

Methods

Observational, retrospective, multicenter study in pts with newly diagnosed locally advanced (not candidate for radical tx) or metastatic NSCLC and KRAS ^G12C. Pts participating in clinical trials with RAS inhibitors were excluded. The study collected clinical and economic data from medical records and administrative databases from 1st Jan 2016 to 9th Mar 2022 (diagnosis period: Jan 2016-Oct 2021).

Results

A total of 127 pts were included (median age 65 years, 71% male, 43%/54% current/former smokers, 82% ECOG≤2, 57% ≥2 metastatic site). PD-L1 expression was analysed in 104 pts at baseline: 19/104 (18%) pts had a PD-L1 expression <1%, 45/104 (43%) pts 1-50%, and 40/104 (39%) pts ≥50%. 94 pts (74%) received systemic tx. The most common first line tx was platinum-based chemotherapy alone (71%). Table shows progression free survival and overall survival. 124 and 103 pts had available global and disease-related (d-r) economic data, respectively. Total global cost over study period was €5,780,686 (total global mean cost per pt: €46,618) with a total pharmacological cost of €2,373,384 (mean cost per pt: €19,140). Total d-r cost was €4,245,504 (total d-r mean cost per pt: €41,218) with a d-r pharmacological cost of €2,177,712 (mean cost per pt: €21,142). Table: 1410P

CI, confidence interval; CTx, chemotherapy; FU, follow up; IO, immunotherapy; m, months; NA, not applicable; NR, not reached; OS, overall survival; PFS, progression free survival; TL, treatment line *Periods due to a major change in Spain: IO can be used as TL 1 from Oct 2017 ^‡Median FU6.8 m ^§Median FU6.6 m

Conclusions

The real-world data confirm limited outcomes for most KRAS^G12C pts and emphasize the high clinical and economic burden of these pts’ care in an evolving tx landscape. Evaluating the impact of new and effective targeted therapies is warranted.

Clinical trial identification

Editorial acknowledgement

Medical writing support provided by Irene Mansilla from TFS HealthScience and funded by Amgen S.A.

Legal entity responsible for the study

Amgen S.A.

Funding

Amgen S.A.

Disclosure

N. Reguart Aransay: Financial Interests, Personal, Advisory Board: Roche, MSD, Takeda, Bayer, Novartis, Sanofi, Janssen, AstraZeneca, Amgen; Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD, Boehringer, Guardant, BMS, Pfizer, Amgen, Novartis. O.J. Juan Vidal: Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, Merck Sharp & Dohme, Lilly, Takeda, AstraZeneca, Janssen; Financial Interests, Personal, Invited Speaker: Roche/Genentech; Financial Interests, Institutional, Funding: AstraZeneca. E. Arriola: Financial Interests, Personal, Advisory Board: Roche, Boehringer Ingelheim, Lilly; Financial Interests, Personal, Invited Speaker: Takeda, MSD, AstraZeneca, BMS, Thermo Fisher Scientific, Guardant Health, Pfizer; Financial Interests, Personal, Other, Co-founder: Trialing Health; Financial Interests, Institutional, Research Grant: AstraZeneca. S. Palanca: Financial Interests, Personal, Speaker, Consultant, Advisor: Roche Pharma, AstraZeneca, Lilly; Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Research Funding: Roche Pharma, AstraZeneca; Financial Interests, Personal, Invited Speaker: Pfizer, Amgen, Takeda; Financial Interests, Personal, Research Grant: Roche Pharma, Amgen. L. Planellas, A. Lloansi Vila: Financial Interests, Personal, Full or part-time Employment: Amgen. All other authors have declared no conflicts of interest.