Presentation (CTI)

OBJECTIVES: Early treatment discontinuation (ETD) is increasingly recognized as a key gap between clinical trial efficacy and real-world outcomes in non-small cell lung cancer (NSCLC). This study explored ETD patterns across Asian settings, with a focus on India, Thailand, and Bangladesh.
METHODS: Publicly available real-world studies (2015-2025) were reviewed. Given limited direct reporting, ETD was assessed using proxies such as treatment completion, duration, and transitions to subsequent lines of therapy.
RESULTS: Across settings, a consistent pattern of early treatment drop-off was observed. In Thailand, 29.4% of patients did not receive second-line therapy¹, suggesting early attrition after first-line treatment. Additionally, only 57% completed planned durvalumab, with 7.3% discontinuing due to adverse events². Outcomes were notably better where targeted therapies were reimbursed, with overall survival improving from 18.3 to 27.2 months¹, highlighting the role of payer support in sustaining treatment. In India, access constraints were more pronounced. Only 13.5% of eligible patients received osimertinib³, and just 58.7% proceeded to second-line therapy after progression⁴, reflecting substantial attrition. Supporting evidence indicates treatment discontinuation is frequently driven by progression or clinical deterioration⁵. For Bangladesh, no registry-based ETD data were identified, pointing to a significant gap in real-world oncology evidence.
CONCLUSIONS: ETD is common in Asian NSCLC care and is driven as much by health system constraints as by clinical factors. Improving access and reimbursement will be critical to improving persistence.