Abstract 124P
Background
PACIFIC established D as the standard of care for patients (pts) with unresectable Stage III NSCLC and no progression after CRT. In retrospective observational studies, such as PACIFIC-R (Girard, 2022), outcomes in pts who receive D after CRT have been consistent with PACIFIC, demonstrating the real-world (RW) effectiveness of this regimen. We report exploratory analyses comparing outcomes in pts who did or did not receive D after concurrent CRT (cCRT) in the retrospective observational SPOTLIGHT study.
Methods
A US oncology database (Flatiron Health) was used to collect de-identified pt-level data from a sample of unresectable Stage III NSCLC pts treated with CRT. Two prespecified cohorts were curated: pts who did or did not receive D. The exploratory endpoints of RW progression-free survival (rwPFS) and overall survival (OS), both defined from the end of CRT, were analyzed by Kaplan–Meier method in pts who completed cCRT and did not progress or die before D start, for the D cohort, or within 42 days from the end of CRT, for the non-D cohort. Cox regression was used to assess the association of D with outcomes, adjusting for available pt characteristics.
Results
The D and non-D cohorts included 332 and 137 pts, respectively; 299 and 77 pts met the above-mentioned criteria for inclusion in the analyses. Pt characteristics were similar between the two groups. Median rwPFS (95% CI), defined from the end of CRT, was 20.0 mo (16.2–not estimable [NE]) in the D group and 10.2 mo (6.7–12.4) in the non-D group. In the Cox regression analysis for rwPFS (adjusting for pt characteristics), pts in the D group had a lower risk of progression or death versus pts in the non-D group (HR 0.36; 95% CI 0.26–0.52). Median OS (95% CI) was not reached in the D group and 24.8 mo (13.4–NE) in the non-D group. In the Cox regression analysis for OS, pts in the D group had a lower risk of death versus pts in the non-D group (HR 0.30; 95% CI 0.19–0.48).
Conclusions
In the RW SPOTLIGHT study, pts who received D after CRT had better outcomes versus pts who did not (e.g. median rwPFS 20.0 vs 10.2 mo). There were no apparent differences in pt characteristics to explain why pts had not received D. Further investigation of factors that led to this is warranted.
Editorial acknowledgement
Medical writing support for the development of this abstract, under the direction of the authors, was provided by Andrew Gannon of Ashfield MedComms (New York, NY, USA), an Inizio company, and was funded by AstraZeneca.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
L. Cai: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. A. Wang: Financial Interests, Personal, Full or part-time Employment, Contractor: AstraZeneca. Y. Qiao: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. P. Chander: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. M. Mooradian: Financial Interests, Personal, Advisory Role: AstraZeneca, Istari Oncology; Financial Interests, Personal, Other, Consulting fee: AstraZeneca, Nektar Therapeutics, Istari Oncology, Catalyst Pharmaceuticals, Xilio Therapeutics; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb. All other authors have declared no conflicts of interest.