Abstract 1379P
Background
Limited data are available on RW outcomes of current mNSCLC treatments in the United Kingdom. By analysing ≈10% of adult UK patients with mNSCLC, this study aimed to fill the data gap by investigating treatment patterns, RW tumor response, overall survival (OS), and time to discontinuation (TTD) in patients who started first-line (1L) treatment. To our knowledge, this is the first large-scale, RW study in mNSCLC in the United Kingdom.
Methods
This retrospective, observational study collected data from electronic prescribing records (EPRs) of patients with mNSCLC who started 1L treatment between June 1, 2016, and March 31, 2018 (minimum follow-up to December 31, 2018). EPR data gaps were supplemented by chart reviews. RW tumor response was based on physician-defined best 1L response of a partial or complete response. Kaplan-Meier method estimated OS and TTD (time to earliest of death or end of treatment).
Results
In total, 1,003 patients were included from 9 UK hospitals. Of these, 698 (70%) received nontargeted chemotherapy (NTC), 179 (18%) received immuno-oncological monotherapy (IO), and 126 (12%) received targeted therapy (TT; EGFR/ALK inhibitors) (Table). Median age was 67 years (range, 28-93 years), and 54% were male. Table: 1379P
Key clinical characteristics and outcomes by drug class in 1L
| NTC (n=698 [70%]) | IO (n=179 [18%]) | TT (n=126 [12%]) | |
| ECOG PS, n (%) | |||
| 0-1 | 513 (74) | 157 (88) | 89 (71) |
| 2+ | 185 (26) | 22 (12) | 37 (29) |
| Histology, n (%) | |||
| Adenocarcinoma | 387 (55) | 131 (73) | 117 (93) |
| Squamous cell | 202 (29) | 38 (21) | 3 (2) |
| Large cell | 4 (1) | 2 (1) | 0 (0) |
| Not specified | 105 (15) | 8 (5) | 6 (5) |
| RW tumor response, n (%) | 187 (27) | 61 (34) | 43 (34) |
| Median OS, months (95% CI) | 8.1 (7.4-8.9) | 14.0 (10.7-20.6) | 20.2 (16.0-30.5) |
| Median TTD, months (95% CI) | 2.1 (1.8-2.1) | 5.3 (4.2-7.2) | 7.6 (5.8-11.5) |
Conclusions
The majority of patients received an NTC regimen as 1L treatment. Results suggested poorer OS in NTC patients. IO resulted in a longer median OS vs NTC; however, this was shorter than that observed in clinical trials. Patients receiving TT had the longest median OS. As innovative IO-based regimens enter practice, future RW studies should investigate whether the proportion of patients receiving NTC alone decreases and outcomes in mNSCLC improve.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Merck KGaA, Darmstadt, Germany and Pfizer Inc.
Funding
This analysis was supported by Merck KGaA, Darmstadt, Germany as part of an alliance between Merck KGaA, Darmstadt, Germany and Pfizer.
Disclosure
J. Lester: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Roche; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Merck Sharp Dohme; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Lilly. C. Escriu: Advisory/Consultancy, Travel/Accommodation/Expenses: Merck Sharp Dohme; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self): Pfizer; Honoraria (self), Travel/Accommodation/Expenses: Roche. E. Hudson: Advisory/Consultancy: Roche; Advisory/Consultancy: Tesaro; Advisory/Consultancy: GlaxoSmithKline. T. Mansy: Honoraria (self), Travel/Accommodation/Expenses: Merck Sharpe Dohme; Honoraria (self), Travel/Accommodation/Expenses: Bristol-Myers Squibb; Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Travel/Accommodation/Expenses: Roche; Honoraria (self), Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self), Travel/Accommodation/Expenses: PharmaMar; Honoraria (self), Travel/Accommodation/Expenses: Tesaro. A. Conn: Research grant/Funding (self): Servier. S. Chan: Honoraria (self): Bristol-Myers Squibb. C. Powell: Honoraria (self), Travel/Accommodation/Expenses: Boehringer Ingelheim; Travel/Accommodation/Expenses: Roche; Honoraria (self): Bristol-Myers Squibb. X. Zhuo: Full/Part-time employment, I was a Merck KgaA employee when the analysis was conducted.: EMD Serono Research & Development Institute, Inc., Billerica, USA; a business of Merck KGaA, Darmstadt, Germany. A. Durand: Full/Part-time employment, I was a Merck KgaA employee when the analysis was conducted.: Merck KGaA. A. Amin: Full/Part-time employment, Merck employee: Merck Serono Ltd., Feltham, United Kingdom; an affiliate of Merck KGaA, Darmstadt, Germany. P. Martin: Full/Part-time employment: Merck Serono Ltd. X. Zhang, V. Pawar: Full/Part-time employment, EMD Serono employee: EMD Serono Research & Development Institute, Inc., Billerica, USA; a business of Merck KGaA, Darmstadt, Germany. All other authors have declared no conflicts of interest.