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E-Poster Display

2007P - Tumour mutational burden (TMB) level and clinical outcomes in a real-world pan-tumour population

Date

17 Sep 2020

Session

E-Poster Display

Presenters

Rich DeClue

Citation

Annals of Oncology (2020) 31 (suppl_4): S1052-S1064. 10.1016/annonc/annonc295

Authors

R. DeClue1, S. Kachroo2, S. Gautam1, M.D. Fisher1, A. Basu3

Author affiliations

  • 1 Outcomes Science & Services, Concerto HealthAI, 38119 - Memphis/US
  • 2 Center For Observational And Real-world Evidence (core), Merck & Co., Inc., Kenilworth/US
  • 3 The Comparative Health Outcomes, Policy, And Economics (choice) Institute, The University of Washington, Seattle/US
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Resources

Abstract 2007P

Background

Currently, there is limited real-world data examining association of TMB levels with clinical and healthcare utilization (HCRU) outcomes.

Methods

Patients ≥18 years, diagnosed with advanced or metastatic solid tumours between 1/1/2015 and 1/31/2019, and had ≥1 numeric TMB result were selected. They were divided into “low-TMB” (TMB <10 mut/Mb) and “high-TMB” groups (TMB ≥10 mut/Mb). Data were abstracted from medical records of community oncology practices maintained in the Vector Oncology Data Warehouse. Kaplan-Meier analysis was used to evaluate overall survival (OS) and progression-free survival (PFS) from the start of first-line (1L) treatment. HCRU and costs during 1L were analyzed using descriptive methods.

Results

Of 202 eligible patients, median age was 62.5 years, 52.0% were male and 71.3% white. There were no significant differences for age, sex and race between the low (N=170) and high-TMB (N=32) groups. The distribution of tumour type differed between groups. For example, more high-TMB patients vs. low-TMB had lung cancer (37.5% vs. 2.4%; p<0.0001). More high-TMB patients had ≥1 comorbid condition (59.4% vs 37.6%; p=0.0219). Of low-TMB patients, 161 (94.7%) received systemic anti-cancer treatment compared to 24 (75.0%) high-TMB. Median OS was 18.3 months (95% CI 15.5-24.8) for low-TMB patients compared to 13.6 (95% CI 10.2-21.8) for the high-TMB group. Median PFS was 9.3 months (95% CI 7.7-10.8) for low-TMB patients and 7.4 months (95% CI 5.0-13.1) for the high-TMB group. HCRU and cost results during 1L treatment are summarized below. Table: 2007P

TMB
Utilization Low (N=161) High (N=24)
Hospitalization, n (%) 33 (20.5%) 4 (16.7%)
Emergency department visit, n (%) 17 (10.6%) 5 (20.8%)
Monthly office visit, mean (SD) 1.6 (1.34) 2.2 (2.20)
Cost of care
Total cost $44,970 $49,814
Monthly cost $11,801 $17,199

Conclusions

In this real-world analysis, only about 1 of 6 cases had a high-TMB score. There were some notable differences in clinical characteristics between low and high-TMB groups. Despite the limited sample size, the results indicate some correlation between TMB level and clinical and HCRU outcomes among those using systemic therapy. Future studies with larger sample size are required to confirm these results and further address confounding.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Merck & Co., Inc.

Funding

Merck & Co., Inc.

Disclosure

R. DeClue: Full/Part-time employment: Concerto HealthAI; Research grant/Funding (institution): Merck & Co., Inc.. S. Kachroo: Shareholder/Stockholder/Stock options, Full/Part-time employment: Merck & Co., Inc.. S. Gautam: Full/Part-time employment: Concerto HealthAI; Research grant/Funding (institution): Merck & Co., Inc.. M.D. Fisher: Full/Part-time employment: Concerto HealthAI; Research grant/Funding (institution): Merck & Co., Inc.. A. Basu: Full/Part-time employment: The University of Washington; Advisory/Consultancy: Merck & Co., Inc..

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