Abstract 1308P
Background
The evolution of treatment in advanced NSCLC has led to increasing use of targeted therapy and immune checkpoint inhibitors. The study goal was to assess the effect of molecular testing and introduction of novel therapeutic options on the use of systemic therapy and overall survival for patients with advanced NSCLC.
Methods
BC Cancer serves a population of 4.6 million Canadians. All patients with stage IV NSCLC referred to BC Cancer were included in the study. One-year time cohorts were chosen based on molecular testing implementation and funded drug availability; baseline (2009), EGFR testing (2011), ALK testing (2015), and immunotherapy availability (2017). Baseline demographics, disease characteristics, and systemic therapy details (agent, duration, line of therapy) were collected retrospectively. OS was calculated using the Kaplan-Meier method and compared using the log-rank test.
Results
3482 patients with stage IV NSCLC were identified. Baseline characteristics: median age at diagnosis 69 years, female 50%, non-squamous 58%, squamous 14%, NOS 28%. In the four time cohorts 2009/2011/2015/2017: systemic therapy was delivered in 34/40/39/40% of the total population, first line treatment with EGFR TKI increased 3/15/21/28% (of total systemic therapy), first line ALK inhibitors 0/0/4/4% and any line immunotherapy 0/1/10/41%. Median OS with BSC 3.4/3.1/3.2/2.9 m (p=0.19) and with systemic treatment 9.9/10.9/13.9/15.0 m (p<0.01).
Conclusions
Following the implementation of testing for driver mutations and introduction of targeted therapy and immunotherapy, the advanced NSCLC OS in this population-based cohort has improved significantly. This demonstrates that it is critical to identify patients appropriately for new and emerging targeted therapies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.