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Poster Display session

35P - Drug treatment management of advanced ALK-positive non-small cell lung cancer in Spain: A real-world cross-sectional analysis


31 Mar 2023


Poster Display session


Maria Eugenia Olmedo Garcia


Journal of Thoracic Oncology (2023) 18 (4S): S35-S88.


M.E.E. Olmedo Garcia1, U. Asensio2, L.F. García2, P. Rebollo3, I. Ricote3, G. Cárdenas4, C. Marcos3

Author affiliations

  • 1 Madrid/ES
  • 2 Pfizer Espana, Madrid/ES
  • 3 IQVIA, Madrid/ES
  • 4 IQVIA, Barcelona/ES


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Abstract 35P


In Spain, new generation ALK inhibitors have been added as new therapeutic options, with specific indications, to those already available for advanced or metastatic ALK-positive non-small cell lung cancer (mNSCLC ALK+). In this context it is key to understand current treatment management of this subpopulation by line in clinical practice, as well as the most prescribed treatment sequences, as in most cases they have not been fully established.


This is a cross-sectional, population-based observational study, based on IQVIA Oncology Advantage dataset, that includes drug-treated anonymized mNSCLC ALK+ patient cases in real clinical practice reported by senior physicians at a quarterly basis in Spain. The sample of 368 mNSCLC ALK+ patients reported between July 2021 and June 2022 was selected for the study. Patients participating in phase II or III clinical trials were excluded (N = 29). A descriptive analysis of all therapeutic regimens prescribed by line was performed (1L, 2L, and 3L+, respectively), using absolute and relative frequencies, as well as an identification of main treatment sequences across lines based on the subpopulation currently on 2L+.


A sample of 339 patients was analyzed, 163 in 1L, 90 in 2L and 86 in 3L+. Patients were mostly treated in 1L with alectinib (N/%) (138/85%), followed by brigatinib (8/5%), the share of the first ALK inhibitor commercialized, crizotinib, of being 4% nowadays. In 2L, alectinib (29/32%), lorlatinib (27/30%), and brigatinib (9/10%) were the most prescribed treatments; and in 3L+, immunotherapy (IO) (27/31%), lorlatinib (18/21%), and platinum-based regimens (18/21%). The most common sequence from 1L to 2L among patients currently on 2L was alectinib-lorlatinib (27/30%). Among patients currently on 3L+, the most prescribed sequences 1L-2L-3L+ were crizotinib-alectinib-lorlatinib (12/14%), and crizotinib-alectinib-IO or alectinib-lorlatinib-IO both in the same proportion (8/9%).


New drugs marketed in Spain for mNSCLC ALK+ patients seem to have gained importance in 2L and 3L. Additional approvals are expected so clinical practice could continue evolving.

Legal entity responsible for the study

IQVIA Information S.A


Pfizer S.L.U


M.E. Olmedo: Non-Financial Interests, Personal, Advisory Role: AstraZeneca, Bristol-Myers Squibb, MSD, Sanofi; Non-Financial Interests, Personal, Speaker's Bureau: Roche, AstraZeneca, Bristol-Myers Squibb, MSD, Pfizer. Ú. Asensio: Non-Financial Interests, Personal, Full or part-time Employment: Pfizer. L.F. García: Non-Financial Interests, Personal, Full or part-time Employment: Pfizer. All other authors have declared no conflicts of interest.

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