ESMO Congress 2023 | OncologyPRO

Abstract 1486P

Background

We describe PDL1 testing, treatment utilization and clinical outcomes in a real-world cohort of metastatic non-small cell lung cancer (mNSCLC) patients in a 2.5-million-member state-mandated health services database in Israel.

Methods

Newly diagnosed mNSCLC patients initiating systemic anti-cancer treatment between 01-Jan-2017-31-Dec-2020 were identified from the National Cancer Registry and Maccabi Healthcare Services database. Overall survival (OS) was estimated using Kaplan Meier analysis. The data cut-off date was 30-June-2021.

Results

Among 843 patients, 85% and 15% had adenocarcinoma (NSQ) and squamous cell carcinoma (SQ) histologies: of these 43% and 26% were female, median age was 67 and 69 years, 73% and 92% ever-smokers, 55% and 48% with 0-1 performance status (PS) respectively. Most patients with NSQ and SQ were tested for PD-L1(83.4% and 89.9% respectively), mostly within 30 days of diagnosis and prior to first-line (1L) treatment initiation. PD-1/PD-L1 inhibitor monotherapy (PDM) or combination (PDC) was the most common 1L therapy for NSQ and SQ histology (49% and 69%). For NSQ patients with no known EGFR/ALK/ROS1 and receiving PDM, PDC and platinum doublet therapy (PDT), the median OS from initiation of 1L was 12.5 (9.9-17.9), 14.8 (10.5-19.4) and 7.5 (6.4-12.2) months respectively, and for a subgroup of patients with PS 0-1, the median OS was 25.1 [4.9-NR], 17.6 [14.3-NR] and 12.7 [9.6-15.1] months respectively.

Table: 1486P

1L systemic anti-cancer treatment patterns in mNSCLC by PD-L1 status, N=843

	Adenocarcinoma	Squamous cell carcinoma
1L Class of anti-cancer systemic therapy n (%)	PD-L1<50 n=344	PD-L1≥50 n=252	Missing n=118	Total n=714	PD-L1<50 n=68	PD-L1≥50 n=48	Total n=129
Platinum doublets	100 (29.0)	2 (0.8)	33 (28)	135 (19.0)	26 (38.2)	4 (8.3)	34 (26.4)
TKI inhibitors	93 (27.0)	53 (21.0)	69 (58.5)	215 (30.1)	1 (1.5)	1 (2.1)	3 (2.3)
PD-1/PD-L1 monotherapy	6 (1.7)	142 (56.3)	2 (1.7)	150 (21.0)	2 (2.9)	33 (68.8)	40 (31.0)
PD-1/PD-L1combinations	137 (39.8)	54 (21.4)	9 (7.6)	200 (28.0)	37 (54.4)	10 (20.8)	49 (38.0)

Drug class “other” for NSQ and SQ and SQ patients with “missing” PDL1 status – not presented here due to n<20. Missing includes patients who were never tested or had an inconclusive test result

Conclusions

Our real-world data supports the benefit of PD-1/PD-L1 inhibitors in patients with mNSCLC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Merck and Co.

Disclosure

A. Arunachalam: Financial Interests, Institutional, Full or part-time Employment: Merck & Co. All other authors have declared no conflicts of interest.