Treatment patterns in patients with advanced non-small cell lung cancer (aNSCLC): real-world data from the United Kingdom

Abstract Background: The treatment landscape for advanced non-small cell lung cancer (aNSCLC) has evolved rapidly since immuno-oncology (IO) therapies were introduced. This study used recent data to assess real-world treatment patterns and clinical outcomes in aNSCLC in the United Kingdom. Methods: Electronic prescribing records of treatment-naive patients starting first-line (1L) treatment for aNSCLC between June 2016 and March 2018 (follow-up until December 2018) in the United Kingdom were assessed retrospectively. Patient characteristics and treatment patterns were analyzed descriptively. Outcomes assessed included overall survival (OS), time to treatment discontinuation, time to next treatment, and real-world tumor response.Results: In all, 1003 patients were evaluated (median age, 68 years [range, 28-93 years]; 53.9% male). Use of 1L IO monotherapy (0%-25.9%) and targeted therapy (11.8%-15.9%) increased during the study period, but chemotherapy remained the most common 1L treatment at all time points (88.2%-58.2%). Median OS was 9.5 months (95% CI, 8.8-10.7 months) for all patients, 8.1 months (95% CI, 7.4-8.9 months) with chemotherapy, 14.0 months (95% CI, 10.7-20.6 months) with IO monotherapy, and 20.2 months (95% CI, 16.0-30.5 months) with targeted therapy. In the 28.6% of patients who received second-line treatment, IO monotherapy was the most common drug class (used in 51.6%).Conclusions: Although use of 1L IO monotherapy for aNSCLC increased in the United Kingdom during the study period, most patients received 1L chemotherapy. An OS benefit for first-line IO monotherapy vs chemotherapy was observed but was numerically smaller than that reported in clinical trials. Targeted therapy was associated with the longest OS, highlighting the need for improved treatment options for tumors lacking targetable mutations.

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Retrospective analysis of real-world treatment patterns and clinical outcomes in patients with advanced non-small cell lung cancer starting first-line systemic therapy in the United Kingdom

BMC Cancer ◽

10.1186/s12885-021-08096-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jason Lester ◽

Carles Escriu ◽

Sarah Khan ◽

Emma Hudson ◽

Talal Mansy ◽

...

Keyword(s):

Lung Cancer ◽

United Kingdom ◽

Targeted Therapy ◽

Small Cell Lung Cancer ◽

Real World ◽

Treatment Patterns ◽

Small Cell ◽

Small Cell Lung ◽

First Line ◽

The United Kingdom

Abstract Background The treatment landscape for advanced non-small cell lung cancer (aNSCLC) has evolved rapidly since immuno-oncology (IO) therapies were introduced. This study used recent data to assess real-world treatment patterns and clinical outcomes in aNSCLC in the United Kingdom. Methods Electronic prescribing records of treatment-naive patients starting first-line (1 L) treatment for aNSCLC between June 2016 and March 2018 (follow-up until December 2018) in the United Kingdom were assessed retrospectively. Patient characteristics and treatment patterns were analyzed descriptively. Outcomes assessed included overall survival (OS), time to treatment discontinuation, time to next treatment, and real-world tumor response. Results In all, 1003 patients were evaluated (median age, 68 years [range, 28–93 years]; 53.9% male). Use of 1 L IO monotherapy (0–25.9%) and targeted therapy (11.8–15.9%) increased during the study period, but chemotherapy remained the most common 1 L treatment at all time points (88.2–58.2%). Median OS was 9.5 months (95% CI, 8.8–10.7 months) for all patients, 8.1 months (95% CI, 7.4–8.9 months) with chemotherapy, 14.0 months (95% CI, 10.7–20.6 months) with IO monotherapy, and 20.2 months (95% CI, 16.0–30.5 months) with targeted therapy. In the 28.6% of patients who received second-line treatment, IO monotherapy was the most common drug class (used in 51.6%). Conclusions Although use of 1 L IO monotherapy for aNSCLC increased in the United Kingdom during the study period, most patients received 1 L chemotherapy. An OS benefit for first-line IO monotherapy vs chemotherapy was observed but was numerically smaller than that reported in clinical trials. Targeted therapy was associated with the longest OS, highlighting the need for improved treatment options for tumors lacking targetable mutations.

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Treatment patterns in extensive-stage small cell lung cancer: A retrospective real-world data study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.288 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 288-288

Author(s):

Apar Kishor Ganti ◽

Kenan Katranji ◽

Brian S. Seal ◽

Lance Brannman

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Real World ◽

Standard Of Care ◽

Treatment Patterns ◽

Small Cell ◽

Small Cell Lung ◽

Real World Data ◽

Extensive Stage

288 Background: Etoposide plus platinum-based chemotherapy (EP) was the first-line (1L) extensive stage small cell lung cancer (ES-SCLC) standard of care for many years. 1L treatment with immunotherapy (durvalumab or atezolizumab) combined with carboplatin (durvalumab, atezolizumab) or cisplatin (durvalumab) chemotherapy (CT) is now being accepted as the new standard of care in this population. This study used real-world data to describe treatment patterns of ES-SCLC patients in the United States following the introduction of immunotherapy (IO). Methods: Data for patients ≥18 years of age with an index ES-SCLC treatment from 17 October 2018 to 30 November 2019 (or no 1L treatment within 60 days of an index diagnosis during this period) were drawn from the Flatiron electronic medical records database. Proportions of patients receiving specific 1L and second-line (2L) treatments were calculated. Times from (a) index diagnosis to 1L start, (b) 1L start to 1L end (c) 1L start to 2L start, and (d) 2L start to 2L end were calculated with 95% confidence intervals (for sample sizes ≥ 30) for the CT and IO+CT treatment categories. Results: 568 patients met the inclusion/exclusion criteria: 77 (14%) were untreated 60 days after their index diagnosis; 491 received 18 different 1L treatments (1L CT: 195; 1L IO+CT: 286, other 1L therapy: 10); and 119 received 2L treatment following 1L CT or IO+CT. The table shows the most frequently occurring 1L and 2L treatments. The mean number of days [#patients, 95% confidence interval] for 1L CT and 1L IO+CT respectively were (a) index diagnosis to 1L start: 22 [194 (1 patient began 1L therapy prior to their index diagnosis); 20–26], 22 [286, 20–24]; (b) 1L start to 1L end: 58 [174, 52–66], 91 [125, 79–103]; (c) 1L start to 2L start: 115 [83, 99–133], 186 [36, 168–205]; (d) 2L start to 2L end: 55 [54, 42–69] and 36 [N = 21]. Conclusions: Most ES-SCLC patients started therapy within a month of diagnosis. Over 50% received 1L IO+CT, reflecting its rapid uptake in the US. Almost 14% patients did not receive 1L treatment and only ~25% of 1L CT and 1L IO+CT patients received 2L therapy within the study period; reasons for this warrant further investigation. [Table: see text]

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