Abstract 1367P
Background
New targeted therapy options for anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer are associated with improved survival, but limited real-world evidence is available on treatment duration and adherence. This study describes real-world use of brigatinib with prior ALK-tyrosine kinase inhibitor (TKI) treatment (TX).
Methods
Adults with ≥ 1 claim for brigatinib (index date; ID) after ≥ 1 prior TKI were identified between 01-Apr-2017 and 31-Aug-2019 from IQVIA’s US-based Longitudinal Pharmacy Claims Database. Patients had ≥ 12 months of observation pre-ID and were followed post-ID until brigatinib discontinuation (≥ 90-day gap in brigatinib therapy), switch to another TKI, or end of follow-up. Time to treatment discontinuation (TTD) was estimated using Kaplan-Meier methods. Brigatinib adherence was measured while on treatment and defined as medication possession ratio ≥ 80%.
Results
In total, 188 patients were included in the study; 43 had only alectinib pre-ID. Of 145 patients with prior crizotinib as first TKI, 102 had at least 1 next-generation (NG) TKI after crizotinib, 68 had alectinib after crizotinib, and 43 had only crizotinib pre-ID (Table). The median (95% confidence interval [CI]) TTD in the overall prior-crizotinib patients was 10.3 (6.5-not reached [NR]) months and ranged from 8.0 (5.7-11.3) months in patients with crizotinib followed by alectinib pre-ID to 10.3 (5.2-NR) months in patients treated only with crizotinib pre-ID. In patients with alectinib only pre-ID, the median TTD was 7.0 (4.6-15.1) months. TTD in prior-crizotinib patients was similar in patients with and without brain metastases. Adherence to TX ranged from 91% to 93%. Table: 1367P
Demographic and outcomes by prior ALK TKI
| Prior-crizotinib (±NG ALK TKI) N=145 | Subsets of prior-crizotinib (±NG ALK TKI) cohort | Prior alectinib only N=43 | |||
| Prior-crizotinib and any NG ALK TKI N=102 | Prior-crizotinib and alectinib (± other NG ALK TKI) N=68 | Prior-crizotinib only N=43 | |||
| Age, median (range) | 57 (21-85) | 56 (30-85) | 55 (30-85) | 58 (21-79) | 61 (31-85) |
| % Female | 62.1 | 60.8 | 64.7 | 65.1 | 48.8 |
| Months of follow-up, mean (SD) | 11.7 (7.6) | 12.1 (7.6) | 12.4 (7.6) | 10.9 (7.6) | 6.9 (4.6) |
| Time to TX discontinuation, months | |||||
| Median | 10.3 | 10.1 | 8.0 | 10.3 | 7.0 |
| 95% CI | 6.5-NR | 6.2-NR | 5.7-11.3 | 5.2-NR | 4.6-15.1 |
| % on therapy at: | |||||
| 6 months | 60.9 | 61.3 | 59.7 | 59.6 | 54.0 |
| 12 months | 45.6 | 44.0 | 35.1 | 50.0 | 40.5 |
| % Adherent | 92.4 | 92.2 | 91.2 | 93.0 | 93.0 |
Conclusions
These real-world results indicate that use of brigatinib may be associated with potential clinical benefit (also in patients with brain metastases). Patients stay on TX for a significant duration of time and have high rates of adherence in later line settings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
IQVIA, Inc.
Funding
Millennium Pharmaceuticals, Inc., Cambridge, MA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited.
Disclosure
H.M. Lin: Shareholder/Stockholder/Stock options, Full/Part-time employment: 1. Millennium Pharmaceuticals, Inc., Cambridge, MA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. Y. Wu: Shareholder/Stockholder/Stock options, Full/Part-time employment: 1. Millennium Pharmaceuticals, Inc., Cambridge, MA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. M. Gorritz: Full/Part-time employment, M. Gorritz is an employee of IQVIA, Inc., which recieved funding from Millenium Pharmaceuticals, Inc. to conduct this research.: IQVIA, Inc. C. McGuiness: Full/Part-time employment, C. McGuiness is an employee of IQVIA, Inc., which received funding from Millennium Pharmaceuticals, Inc. to conduct this research.: IQVIA, Inc. W-T. Huang: Full/Part-time employment, W-T. Huang is an employee of IQIVA, Inc., which received funding from Millennium Pharaceuticals, Inc. to conduct this research.: IQVIA, Inc. C-C. Chen: Full/Part-time employment, C-C. Chen is an employee of IQVIA, Inc., which received funding from Millenium Pharmaceuticals, Inc. to conduct this research.: IQVIA, Inc. M. Jahanzeb: Research grant/Funding (self): Eli Lilly; Research grant/Funding (self): Boehringer Ingelheim; Research grant/Funding (self): Callisto; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Novartis; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Roche Genentech; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Pfizer; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Takeda; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Puma; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): BMS; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): AstraZeneca; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Merck.