1453P - Trends in treatment regimens and survival in the use of immune checkpoint inhibitors for lung cancer treatment in the Netherlands from 2016-2020

Background

Immune checkpoint inhibitors (ICIs) have revolutionized lung cancer (LC) treatment. This study aims to describe the trends of ICI in LC treatment.

Methods

We evaluated treatment regimens and clinical outcomes in the use of ICIs for LC in the Netherlands from 2016-2020 using data from the Netherlands Cancer Registry (NCR) on first-line treatments, and performed a secondary analysis using a local cohort within the University Medical Center Groningen (UMCG) containing all-line treatments. Between 2016-2018, the NCR contained mostly data from patients treated in randomized controlled trials (RCTs) as clinical guidelines advised ICIs only in later treatment lines, whilst NCR data from 2018-2020 and from the UMCG from 2016-2020 were mainly collected outside RCTs. Descriptive statistics and annual percentage change (APC) were used to evaluate changes over time. Also, a survival analysis was performed.

Results

The proportion of first-line ICIs in LC treatment increased from 1.1% in 2016 to 54.9% in 2020 in the Netherlands (6816 patients in total, APC=14.5%, p=0.002). In the UMCG, increases were observed in the proportion of any-line ICI-chemotherapy combination (APC=12.4%, p=0.049), patients surviving ≥1 year (APC=5.8%, p<0.001), and partial response as best overall treatment response (APC=9%, p=0.049), whilst NCR data showed no significant changes over the years. NCR median overall survival (OS) was higher in the period 2016-2018 compared to 2019-2020 (83.4 vs 72.7 weeks, p=<0.001), whilst in the UMCG, 2016-2018 showed a lower median OS compared to 2019-2020 (39.3 [95%CI 32.9-48.6] vs 72.4 weeks [95%CI 52.7-87.4]).

Conclusions

The use of ICIs for LC treatment in the Netherlands increased over the years. Survival data showed better response in the use of ICI as any-line treatment in the UMCG from 2019-2020, contrary to data from patients in the NCR. An explanation for this is the inclusion of mainly RCT patients in the NCR data during the early years of ICI use and the recent shift from second to first-line treatment. As new ICI based drugs emerge, updated analyses will be needed using real-world data to evaluate the real benefits of these newly developed treatments.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Mexico’s National Council of Science and Technology (CONACYT) [Grant No. 1074186] European Union’s Horizon 2020 research and innovation program [grant number 875171].

Disclosure

All authors have declared no conflicts of interest.