scholarly journals Treatment patterns in patients with metastatic non-small-cell lung cancer in the era of immunotherapy

2021 ◽  
Author(s):  
David Stenehjem ◽  
Solomon Lubinga ◽  
Keith A Betts ◽  
Wenxi Tang ◽  
Mads Jenkins ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stage Iv ◽  
Treatment Patterns ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Programmed Death ◽  
Baseline Characteristics

Background: Chemotherapy (CT) alone was previously standard first-line (1L) therapy for metastatic non-small-cell lung cancer (NSCLC) but alternative treatments, including immunotherapy (I-O), are now available. Patients & methods: In this retrospective study, adults with stage IV NSCLC who initiated 1L treatment between 1 August 2018 and 31 December 2019 and had ≥2 visits were identified in the Flatiron database. Patients were followed up until 30 June 2020. Baseline characteristics and treatment patterns were described by treatment group: CT, I-O + CT, I-O monotherapy and other. Results: Approximately 20% of patients received 1L CT in the 2018–2019 timeframe studied; these patients tended to have squamous histology and low (≤49%) programmed death ligand-1 expression. Conclusion: A proportion of patients with metastatic NSCLC still receive 1L CT despite the availability and widespread use of I-O therapies.

scholarly journals Treatment Patterns and Overall Survival Associated with First-Line Systemic Therapy for Patients with Advanced Non-Small Cell Lung Cancer

2017 ◽  
Vol 23 (2) ◽  
pp. 195-205 ◽  
Author(s):  
Michele M. Spence ◽  
Rita L. Hui ◽  
Jennifer T. Chang ◽  
Joanne E. Schottinger ◽  
Mirta Millares ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Treatment Patterns ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line

First-line systemic treatment with gefitinib in stage IV non-small cell lung cancer

2005 ◽  
Author(s):  
Tobias Lange ◽  
Carsten Müller-Tidow ◽  
Hubert Serve ◽  
Petra Hoffknecht ◽  
Wolfgang Berdel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Treatment ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line

scholarly journals First line Immunotherapy for Non-Small Cell Lung Cancer

2020 ◽  
Vol 13 (11) ◽  
pp. 373
Author(s):  
Nicola J. Nasser ◽  
Miguel Gorenberg ◽  
Abed Agbarya
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Single Agent ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Phase 3 ◽  
Programmed Death

Immunotherapy for non-small cell lung cancer (NSCLC) is incorporated increasingly in first line treatments protocols. Multiple phase 3 studies have tested different medications targeting programmed death receptor 1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), with or without chemotherapy. The inclusion criteria differ between the various clinical trials, including the cut-off levels of PD-L1 expression on tumor cells, and the tumor histology (squamous or non-squamous). Patients with tumor expression levels of PD-L1 ≥ 50% are candidates for treatment with single agent Pembrolizumab or Atezolizumab. Patients with PD-L1 < 50% are candidates for immunotherapy with pembrolizumab as a single agent if PL-1 > 1%; immunotherapy doublet, Nivolumab and Ipilimumab, or single agent immunotherapy combined with chemotherapy. Here we review phase 3 clinical trials utilizing immunotherapy in the first line for treatment of NSCLC, including Pembrolizumab in KEYNOTE-024, KEYNOTE-042, KEYNOTE-189 and KEYNOTE-407; Nivolumab and Ipilimumab in CHECKMATE-227 and CHECKMATE 9LA; and Atezolizumab in IMpower110, IMpower130 and IMpower150.

scholarly journals Phase II Trial of Atezolizumab As First-Line or Subsequent Therapy for Patients With Programmed Death-Ligand 1–Selected Advanced Non–Small-Cell Lung Cancer (BIRCH)

2017 ◽  
Vol 35 (24) ◽  
pp. 2781-2789 ◽  
Author(s):  
Solange Peters ◽  
Scott Gettinger ◽  
Melissa L. Johnson ◽  
Pasi A. Jänne ◽  
Marina C. Garassino ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Programmed Death Ligand 1 ◽  
Programmed Death ◽  
Independent Review

Purpose BIRCH was designed to examine the efficacy of atezolizumab, a humanized anti–programmed death-ligand 1 (PD-L1) monoclonal antibody, in advanced non–small-cell lung cancer (NSCLC) across lines of therapy. Patients were selected on the basis of PD-L1 expression on tumor cells (TC) or tumor-infiltrating immune cells (IC). Patients and Methods Eligible patients had advanced-stage NSCLC, no CNS metastases, and zero to two or more lines of prior chemotherapy. Patients whose tumors expressed PD-L1 using the SP142 immunohistochemistry assay on ≥ 5% of TC or IC (TC2/3 or IC2/3 [TC or IC ≥ 5% PD-L1–expressing cells, respectively]) were enrolled. Atezolizumab 1,200 mg was administered intravenously every 3 weeks. Efficacy-evaluable patients (N = 659) comprised three cohorts: first line (cohort 1; n = 139); second line (cohort 2; n = 268); and third line or higher (cohort 3; n = 252). The primary end point was independent review facility–assessed objective response rate (ORR; Response Evaluation Criteria in Solid Tumors [RECIST] version 1.1). Secondary end points included median duration of response, progression-free survival, and overall survival (OS). Results BIRCH met its primary objective of demonstrating a significant ORR versus historical controls. With a minimum of 12 months of follow-up, the independent review facility–assessed ORR was 18% to 22% for the three cohorts, and 26% to 31% for the TC3 or IC3 subgroup; most responses are ongoing. Responses occurred regardless of EGFR or KRAS mutation status. The median OS from an updated survival analysis (minimum of 20 month follow up) for cohort 1 was 23.5 months (26.9 months for TC3 or IC3 patients); the median OS in cohorts 2 and 3 was 15.5 and 13.2 months, respectively. The safety profile was similar across cohorts and consistent with previous atezolizumab monotherapy trials. Conclusion BIRCH demonstrated responses with atezolizumab monotherapy in patients with PD-L1–selected advanced NSCLC, with good tolerability. PD-L1 status may serve as a predictive biomarker for identifying patients most likely to benefit from atezolizumab.

Treatment intensity and duration in patients receiving first-line taxane chemotherapy for stage IV non-small cell lung cancer.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e19011-e19011
Author(s):  
Jared Weiss ◽  
Rex W. Force ◽  
Brooke A. Pugmire ◽  
Teri Peterson ◽  
Claudio Faria ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stage Iv ◽  
Small Cell ◽  
Treatment Intensity ◽  
Small Cell Lung ◽  
First Line ◽  
Taxane Chemotherapy

Treatment sequences in non-small cell lung cancer in the United States from 2014-2016.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 237-237
Author(s):  
Lisa M. Hess ◽  
Zhanglin Lin Cui ◽  
Xiaohong Li ◽  
Julie Beyrer ◽  
Ana Belen Oton
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Single Agent ◽  
The United States ◽  
Treatment Patterns ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Treatment Sequencing

237 Background: A number of important advancements in the treatment of metastatic non-small cell lung cancer (mNSCLC) have increased and diversified options for improved patient care based on individual characteristics. The ability to tailor therapy increases the challenges related to appropriate treatment sequencing. This study was designed to describe these emerging treatment patterns following the approval of novel targeted agents. Methods: Flatiron Health OncoEMR, a nationally-representative electronic medical records database in the US, was used to evaluate treatment patterns by histology (squamous and nonsquamous). Eligible patients were 18+ years of age who initiated 2ndline therapy for mNSCLC from Dec 2014-Jul 2016. Descriptive statistics were used to characterize the clinical and demographic characteristics of the study population, treatments used by line of therapy, and treatment sequencing. Analyses were conducted using SAS version 9.2. Results: A total of 3498 eligible patients were included in this study: 51.3% male; mean age 66.6 years; 65% white; 25% squamous/70.7% nonsquamous (4.3% not specified); and 93% were treated at community practices. ALK testing was performed on 20.0%/74.8%, EGFR testing on 21.5%/79.8%, and PDL-1 on 8.6%/9.7% of patients with squamous/nonsquamous tumors, respectively. Single-agent PDL-1 inhibitors were used by 54.2% of squamous and 35.2% of nonsquamous patients in the 2nd-line setting; however, there were more than 35 (squamous) and 64 (nonsquamous) unique first-line regimens prior to single-agent PDL-1 treatment. Other 2nd-line regimens included pemetrexed (24.9% of nonsquamous patients) and gemcitabine (18.4% of squamous patients), which were preceded by 70 and 48 unique first-line regimens, respectively. Conclusions: There is interest in understanding treatment sequencing to identify the optimal sequence of care for patients with NSCLC; however, there was considerable heterogeneity in sequencing. Since few patients follow any similar trajectory of care, comparative effectiveness research will be challenged to appropriately balance groups due to insufficient patient numbers in any specific treatment sequence.

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