1390P - Real-world characteristics, treatment patterns and outcomes of patients with advanced HER2/ERBB2-mutant non-small cell lung cancer (NSCLC) in France and Germany

Background

HER2 mutations (HER2m) are a potential therapeutic target in 2–3% of patients with non-squamous NSCLC; however, real-world evidence on demographics and outcomes is limited. We assessed patient characteristics and treatment patterns for advanced HER2m NSCLC at a French and a German academic centre.

Methods

Adults with advanced HER2m non-squamous NSCLC were identified at Institut Curie, France (study: 1 Jan 2011–22 Apr 2022) and Thoraxklinik Heidelberg, Germany (1 Jan 2014–5 May 2022). Lines of therapy (L) and treatment pathways were characterised. Demographic/clinical characteristics were analysed by descriptive statistics; survival was assessed by Kaplan–Meier analysis. Real-world progression-free survival (rwPFS) was time between L start and earliest progression event (Germany), discontinuation due to progression (France), next L start or death.

Results

Of 55 patients with advanced HER2m NSCLC (n=17, France; n=38, Germany), the median age at diagnosis was 66 years, 63.6% were female and 74.6% had ECOG scores of 0 or 1. 48 patients (87.3%) received at least 1L, 29 (52.7%) received at least 2L and 19 (34.5%) received at least 3L. The most common regimens were carboplatin + pemetrexed (13/48, 27.1%) and carboplatin + pemetrexed + pembrolizumab (9/48, 18.8%) in 1L and pembrolizumab (6/29, 21.0%), carboplatin + pembrolizumab + pemetrexed (3/29, 10.3%) and pemetrexed (3/29, 10.3%) in 2L. The most common treatment pathway began with non-platinum-based chemotherapy or platinum-based chemotherapy in 1L (26/48, 54.2%) and immunotherapy in 2L (7/26, 26.9%) (Table). Median real-world overall survival from the start of 1L was 16.5 months (95% CI: 12.3–29.8). Median rwPFS in the 1L was 5.1 months (95% CI: 3.5–8.5).

Conclusions

Chemotherapy was the mainstay in 1L; diverse regimens were used in 2L. Poor survival suggests a need for novel therapeutic options for advanced HER2m NSCLC. Table: 1390P

^aNeratinib, afatinib, poziotinib, trastuzumab, or trastuzumab emtansine. ^bAlectinib, bevacizumab, ceritinib, or ramucirumab. IMT, immunotherapy; non-plat, non-platinum-based chemotherapy; plat, platinum-based chemotherapy.

Clinical trial identification

Editorial acknowledgement

Medical writing and editorial assistance were provided by Julia C. Jones (PharmD, PhD), Erica Cave (PhD), and Daria Renshaw from IQVIA, funded by the study sponsors.

Legal entity responsible for the study

AstraZeneca, Daiichi Sankyo.

Funding

AstraZeneca, Daiichi Sankyo.

Disclosure

P. Christopoulos: Financial Interests, Personal, Advisory Board: AstraZeneca, Boehringer Ingelheim, Chugai, Pfizer, Novartis, MSD, Takeda, Roche, Daiichi Sankyo; Financial Interests, Personal, Writing Engagement: Gilead; Financial Interests, Personal, Invited Speaker: Thermo Fisher; Financial Interests, Institutional, Funding: AstraZeneca, Boehringer Ingelheim, Amgen, Novartis, Roche; Financial Interests, Personal, Funding: Takeda. 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, Officer, International Thymic malignancy interest group, president: ITMIG; Other, Family member is an employee: AstraZeneca. L. Zhang: Financial Interests, Personal, Full or part-time Employment: Daiichi Sankyo; Financial Interests, Institutional, Funding, Funding for study and publication: Daiichi Sankyo, AstraZeneca. Z. Mbanya: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. K. Dunton: Financial Interests, Personal, Full or part-time Employment: Daiichi Sankyo. A. Ali: Financial Interests, Personal, Full or part-time Employment: Daiichi Sankyo; Financial Interests, Personal, Full or part-time Employment, Prior employer: AstraZeneca. M. Berktas: Financial Interests, Personal, Other, I receive regular consultancy fee for my scientific services, I am the project lead for the project from which 2 abstracts were created and submitted to ESMO 2023 congress: AstraZeneca. L. Delmastro: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Institutional, Funding, Funding for study & publication: AstraZeneca, Daiichi Sankyo. A. Struebing: Financial Interests, Personal, Full or part-time Employment: Daiichi Sankyo. Y. Xiong: Financial Interests, Personal, Full or part-time Employment: Daiichi Sankyo; Financial Interests, Personal, Full or part-time Employment, Prior employer: Becton Dickinson. S. Lay-Flurrie: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Personal, Full or part-time Employment, Previous employer: University of Oxford; Financial Interests, Institutional, Funding, Funding for study & publication: AstraZeneca, Daiichi Sankyo. P. Hindocha: Financial Interests, Institutional, Funding, Funding for study & publication: AstraZeneca, Daiichi Sankyo; Financial Interests, Personal, Full or part-time Employment: IQVIA. T. Mehdikhanova: Financial Interests, Institutional, Funding, Funding for study and publication: AstraZeneca, Daiichi Sankyo; Financial Interests, Personal, Full or part-time Employment: IQVIA.