Abstract 96P
Background
There are limited data on real world usage of neoadjuvant (neo) treatment (tx) in clinical practice in non-metastatic non-small cell lung cancer (nmNSCLC). As immunotherapies (IO) emerge in the resectable setting, we aimed to describe characteristics and tx patterns of patients (pts) receiving neo tx for resectable nmNSCLC.
Methods
Data were drawn from the Adelphi nmNSCLC Disease Specific Programme™, a point in time survey of 274 oncologists/pulmonologists/surgeons in France (FR), Germany (DE), Italy (IT), Spain (ES), United Kingdom (UK) and Canada (CA) between Apr-Nov 2022. Physicians provided information on their next four consulting pts with resectable nmNSCLC [random] (n = 1074) and an additional four pts receiving/received any neo and/or adjuvant tx [oversample] (n = 1090).
Results
Of 1074 random pts, 208 (19.4%) received neo tx; country splits were 45/203 (22.2%) FR, 36/200 (18.0%) DE, 39/205 (19.0%) IT, 49/200 (24.5%) ES, 30/198 (15.2%) UK and 9/68 (13.2%) CA. Characteristics of pts who did and did not receive neo tx [random and oversample] are shown in the table. Of 739 neo pts, cisplatin + vinorelbine (18.8%), carboplatin + paclitaxel (11.0%) and cisplatin + gemcitabine (9.6%) were the most common txs initially received. Radiotherapy was administered to 22.2% alongside or subsequent to neo tx. Pathological response for pts who concluded neo tx (n = 251) was complete in 12.0%, major in 43.8%, and neither complete nor major in 22.7%. Top three reasons for prescribing neo tx were to; improve overall survival (OS) (64.1%), facilitate surgery of resectable pts (60.5%) and improve event-free survival (42.8%).
Table: 96P| Received neo tx (n = 739) | Received surgery without neo tx (n = 1425) | |
|---|---|---|
| Age (mean, years) | 63.2 | 64.9 |
| Male, % | 65.2 | 64.1 |
| Stage at dx*, % | ||
| 0–IIB | 28.8 | 77.9 |
| IIIA–C | 66.6 | 16.0 |
| Unknown | 4.6 | 6.1 |
| Histology, % | ||
| Squamous cell | 37.8 | 37.2 |
| Adenocarcinoma | 55.9 | 58.2 |
| Large cell carcinoma | 5.0 | 3.6 |
| Other | 0.8 | 0.5 |
| Unknown | 0.5 | 0.4 |
| ECOG PS at dx, % | ||
| 0–1 | 93.4 | 93.2 |
| 2+ | 6.0 | 6.0 |
| Unknown | 0.7 | 0.8 |
| Biomarker testing, % | ||
| PD-L1 | 62.1 | 62.9 |
| Driver mutations** | 58.9 | 60.4 |
| PD-L1 expression, % | n = 450 | n = 872 |
| <1% | 28.7 | 31.3 |
| 1–49% | 58.2 | 54.9 |
| ≥50% | 13.1 | 13.8 |
| Driver mutations** results prior to tx, % | n = 435 | n = 861 |
| Yes (some/all results) | 79.3 | 76.9 |
8th TNM edition
**EGFR, ALK, ROS1, RET, BRAF, MET, KRAS dx, diagnosis; tx, treatment; ECOG, Eastern Cooperative Oncology Group
Conclusions
Neo tx was prescribed to one third of nmNSCLC pts, two thirds of whom were stage IIIA–C at diagnosis. Prescribing neo tx aimed to improve OS and facilitate surgery of resectable pts. With recent advances in neo IO tx showing benefits over chemotherapy, neo tx may be a realistic option for more pts.
Legal entity responsible for the study
Adelphi Real World.
Funding
Has not received any funding.
Disclosure
H. Bailey: Financial Interests, Institutional, Full or part-time Employment: Adelphi Real World.
S. Lucherini: Financial Interests, Personal, Stocks/Shares: Bristol Myers Squibb; Non-Financial Interests, Institutional, Full or part-time Employment: Bristol Myers Squibb.
H. Burlison: Financial Interests, Institutional, Full or part-time Employment: Adelphi Real World.
P. Lam: Financial Interests, Personal, Stocks/Shares: Bristol Myers Squibb; Non-Financial Interests, Institutional, Full or part-time Employment: Bristol Myers Squibb.
L. Vo: Financial Interests, Personal, Stocks/Shares: Bristol Myers Squibb; Non-Financial Interests, Institutional, Full or part-time Employment: Bristol Myers Squibb.
N. Varol: Financial Interests, Personal, Stocks/Shares: Bristol Myers Squibb; Non-Financial Interests, Institutional, Full or part-time Employment: Bristol Myers Squibb.