REAL-WORLD (RW) TREATMENT PATTERNS AND OUTCOMES IN PATIENTS WITH =2 LINES OF THERAPY (LOTS) FOR RECURRENT OR PROGRESSIVE ENDOMETRIAL CANCER
Author(s)
Rachel Bhak, MS1, Neeraj N. Iyer, PhD1, Audrey Hopkins, PhD1, Murat M. Ikiisik, MD2, Edward Kavalerchik, MD1, Mala Talekar, MBBS1, Xinye Li, ScM3, Nada Boualam, PhD3, Prakirthi Yerram, PharmD3, Fernanda Musa, MD4;
1Genmab, Princeton, NJ, USA, 2Genmab, Utrecht, Netherlands, 3Flatiron Health, New York, NY, USA, 4Providence-Swedish Cancer Institute, Seattle, WA, USA
1Genmab, Princeton, NJ, USA, 2Genmab, Utrecht, Netherlands, 3Flatiron Health, New York, NY, USA, 4Providence-Swedish Cancer Institute, Seattle, WA, USA
OBJECTIVES: Describe RW treatment patterns and clinical outcomes among patients with endometrial cancer treated with ≥2 LOTs in the recurrent setting, where no clear standard of care exists.
METHODS: This retrospective observational study used the US Flatiron Health Research Database (2013-2024). Eligible patients had received prior platinum chemotherapy and initiated ≥2 LOTs. Baseline characteristics were assessed. RW treatment patterns, including regimen distribution, time to next treatment (rwTNT), and time to treatment discontinuation (rwTTD), were described for 2L, 3L, and 4L. Kaplan-Meier methods estimated rwTNT, rwTTD, and RW progression-free survival (rwPFS) and overall survival (rwOS).
RESULTS: Of 1397 patients, median age at diagnosis was 67 years. Patients were distributed across the US. Most were treated in community settings (75.2%) and had commercial insurance (63.9%). Patients received a median of 3 LOTs. At initiation of 2L, 55.5% had ECOG PS 0-1. Most patients were overweight (28.1%) or obese (48.9%). Common concomitant medications included granulocyte colony-stimulating factors (24.2%) and steroids (64.1%). Treatment regimens were heterogeneous. Platinum rechallenge decreased by LOT (2L, 31.2%; 3L, 21.9%; 4L, 15.5%), while nonplatinum chemotherapy use increased (20.9%, 26.9%, and 30.5%, respectively). Immune checkpoint inhibitor (ICI)-containing regimens were used in 25%-27% of patients across LOTs; ICI + tyrosine kinase inhibitor combinations constituted about half of these. Hormone and other therapies accounted for 25%-29%. Median rwTNT decreased from 6.9 months in 2L to 5.3 months in 4L. Median rwTTD: 2L, 3.7 months; 3L, 3.2 ; 4L, 2.9. Clinical outcomes declined by LOT. Median rwPFS: 2L, 5.8 months; 3L, 5.1; 4L, 4.1. Median rwOS: 2L, 16.4 months; 3L, 15.8; 4L: 10.5.
CONCLUSIONS: Treatment regimens were diverse, with increasing reliance on nonplatinum-based chemotherapy in later lines. Clinical outcomes were poor and worsened with each successive LOT, underscoring the need for innovative and effective treatment options earlier in the treatment sequence.
METHODS: This retrospective observational study used the US Flatiron Health Research Database (2013-2024). Eligible patients had received prior platinum chemotherapy and initiated ≥2 LOTs. Baseline characteristics were assessed. RW treatment patterns, including regimen distribution, time to next treatment (rwTNT), and time to treatment discontinuation (rwTTD), were described for 2L, 3L, and 4L. Kaplan-Meier methods estimated rwTNT, rwTTD, and RW progression-free survival (rwPFS) and overall survival (rwOS).
RESULTS: Of 1397 patients, median age at diagnosis was 67 years. Patients were distributed across the US. Most were treated in community settings (75.2%) and had commercial insurance (63.9%). Patients received a median of 3 LOTs. At initiation of 2L, 55.5% had ECOG PS 0-1. Most patients were overweight (28.1%) or obese (48.9%). Common concomitant medications included granulocyte colony-stimulating factors (24.2%) and steroids (64.1%). Treatment regimens were heterogeneous. Platinum rechallenge decreased by LOT (2L, 31.2%; 3L, 21.9%; 4L, 15.5%), while nonplatinum chemotherapy use increased (20.9%, 26.9%, and 30.5%, respectively). Immune checkpoint inhibitor (ICI)-containing regimens were used in 25%-27% of patients across LOTs; ICI + tyrosine kinase inhibitor combinations constituted about half of these. Hormone and other therapies accounted for 25%-29%. Median rwTNT decreased from 6.9 months in 2L to 5.3 months in 4L. Median rwTTD: 2L, 3.7 months; 3L, 3.2 ; 4L, 2.9. Clinical outcomes declined by LOT. Median rwPFS: 2L, 5.8 months; 3L, 5.1; 4L, 4.1. Median rwOS: 2L, 16.4 months; 3L, 15.8; 4L: 10.5.
CONCLUSIONS: Treatment regimens were diverse, with increasing reliance on nonplatinum-based chemotherapy in later lines. Clinical outcomes were poor and worsened with each successive LOT, underscoring the need for innovative and effective treatment options earlier in the treatment sequence.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD38
Topic
Health Service Delivery & Process of Care
Disease
SDC: Oncology, STA: Biologics & Biosimilars