Abstract 51P
Background
In a previous study, we reported real-world PD-L1 testing rates, treatment patterns, and outcomes for patients with advanced non-small cell lung cancer (NSCLC) in the era of immuno-oncology in Sweden. In this follow-up study, with additional patients and 12 more months follow-up, the aim was further investigation with a focus on overall survival (OS) in the Swedish setting.
Methods
Data were extracted from the Swedish National Lung Cancer Registry for patients with unresectable stage IIIB-IV NSCLC and ECOG performance status (PS) 0–2 who initiated first-line (1L) PD-(L)1-based regimen from Apr 1, 2017 to Jun 30, 2021, with data cutoff Jun 30, 2022. Kaplan-Meier analysis was used to assess OS by histology and by PD-(L)1 combination therapy (combo) and monotherapy (mono) in patients with ECOG PS 0–1, where index date was defined as the start of 1L therapy.
Results
Of 1153 eligible patients, 669 (58%) received PD-(L)1 inhibitor combo and the remaining PD-(L)1 mono. The vast majority of patients treated with PD-(L)1 inhibitors initiated a pembrolizumab-based regimen: 294 (96%) and 62 (97%) initiated a pembrolizumab-based combo and 504 (85%) and 147 (76%) initiated pembrolizumab mono, in patients with nonsquamous and squamous histology, respectively. The table presents baseline demographics and OS data by histology and by type of PD-(L)1 regimen in patients with ECOG PS 0–1. For reference, in patients receiving 1L platinum-based combination regimen with ECOG PS 0–1 in this Registry, median OS was 10.2 and 11.7 months and the 12-month OS rate was 43.7% and 49.9% in patients with nonsquamous and squamous histology, respectively.
Table: 51PBaseline demographics and OS by histology in patients with ECOG PS 0–1
| Nonsquamous | Squamous | |||
|---|---|---|---|---|
| PD-(L)1 combo N = 305 | PD-(L)1 mono N = 590 | PD-(L)1 combo N = 64 | PD-(L1) mono N = 194 | |
| Female, % | 57.0 | 58.0 | 40.6 | 39.7 |
| Age, mean (SD), years | 68.0 (8.9) | 70.3 (8.5) | 68.3 (7.6) | 71.8 (8.2) |
| Event, N | 124 | 262 | 23 | 90 |
| Median OS (95% CI), months | 20.6 (15.9, 26.9) | 19.8 (17.6, 24.4) | 18.9 (14.1, NE) | 15.0 (11.6, 17.2) |
| OS rate (95% CI), % | ||||
| At 12 months | 64.9 (58.9, 71.5) | 64.2 (59.8, 68.9) | 71.3 (59.2, 86.0) | 57.8 (49.8, 67.1) |
| At 24 months | 45.4 (38.6, 53.3) | 45.9 (41.1, 51.2) | 44.6 (30.3, 65.6) | 30.6 (22.9, 41.0) |
| At 36 months | 33.1 (25.7, 42.6) | 33.1 (28.3, 38.8) | NE (NE, NE) | 19.4 (12.6, 30.0) |
Conclusions
Updated OS data from this nationally representative patient cohort with advanced NSCLC in Sweden are generally in alignment with OS results reported from PD-(L)1 inhibitor clinical trials, supporting the benefit of PD-(L)1 inhibitors as frontline therapy in clinical practice.
Legal entity responsible for the study
Merck & Co., Inc.
Funding
Merck & Co., Inc.
Disclosure
G. Wagenius: Financial Interests, Personal, Sponsor/Funding: MSD. A. Vikström: Financial Interests, Personal, Sponsor/Funding: MSD. A. Berglund: Financial Interests, Personal, Sponsor/Funding: MSD. S. Salomonsson: Financial Interests, Personal, Full or part-time Employment: MSD; Financial Interests, Personal, Stocks/Shares: MSD. G. Bencina: Financial Interests, Personal, Full or part-time Employment: MSD; Financial Interests, Personal, Stocks/Shares: MSD. X. Hu: Financial Interests, Personal, Full or part-time Employment: Merck; Financial Interests, Personal, Stocks/Shares: Merck. D.R. Chirovsky: Financial Interests, Personal, Full or part-time Employment: Merck; Financial Interests, Personal, Stocks/Shares: Merck. H. Brunnström: Financial Interests, Personal, Sponsor/Funding: MSD.