Descriptive Comparison of Patient Characteristics and Treatment Patterns in Metastatic NSCLC: US and France Cohorts to Inform Transportability
Author(s)
Alison ANTOINE, PhD1, Mathieu Robain, MD, PhD2, Philani Mpofu, PhD1, Elsie Horne, PhD1, Harlan Pittell, PhD1, Qianyi Zhang, MS1, Amit Samani, MD, PhD1, Per-Olof Thuresson, MSc3, Thomas Filleron, PhD4, Matthieu Carton, MD, PhD5, Xiaolong Jiao, MS, MD6, Olga Tymejczyk, PhD, MPH7, Marian Eberl, MSc8, Maurice Pérol, MD9, Christos CHOUAID, MD, PhD10, Nicolas Girard, MD11, Didier Debieuvre, MD12, Xavier QUANTIN, MD13, Hervé Léna, MD14, David PEROL, MD15, Blythe Adamson, MPH, PhD1.
1Flatiron Health, New York, NY, USA, 2Data Direction, Unicancer, Paris, France, 3Global Access, Roche Products Ltd, Basel, Switzerland, 4Biostastistic and Health Data science Unit, Institut Claudius Régaud IUCT-O, TOULOUSE, France, 5Department of Biostatistics, Institut Curie, Paris, France, 6Pfizer, New York, NY, USA, 7Daiichi Sankyo Inc, Basking Ridge, NJ, USA, 8Daiichi Sankyo Europe GmbH, Munich, Germany, 9Department of Medical Oncology, Centre Léon Bérard, Lyon, France, 10Pneumology Department, CHI Creteil France, Créteil, France, 11Institut Curie, Paris, France, 12Pneumology Department, Groupe hospitalier de la région de Mulhouse Sud Alsace, Mulhouse, France, 13Department of Medical Oncology, Institut régional du cancer de Montpellier, Montpellier, France, 14Pneumology Department, Centre Hospitalier Universitaire, Rennes, France, 15Clinical Research Department, Centre Léon Bérard, Lyon, France.
1Flatiron Health, New York, NY, USA, 2Data Direction, Unicancer, Paris, France, 3Global Access, Roche Products Ltd, Basel, Switzerland, 4Biostastistic and Health Data science Unit, Institut Claudius Régaud IUCT-O, TOULOUSE, France, 5Department of Biostatistics, Institut Curie, Paris, France, 6Pfizer, New York, NY, USA, 7Daiichi Sankyo Inc, Basking Ridge, NJ, USA, 8Daiichi Sankyo Europe GmbH, Munich, Germany, 9Department of Medical Oncology, Centre Léon Bérard, Lyon, France, 10Pneumology Department, CHI Creteil France, Créteil, France, 11Institut Curie, Paris, France, 12Pneumology Department, Groupe hospitalier de la région de Mulhouse Sud Alsace, Mulhouse, France, 13Department of Medical Oncology, Institut régional du cancer de Montpellier, Montpellier, France, 14Pneumology Department, Centre Hospitalier Universitaire, Rennes, France, 15Clinical Research Department, Centre Léon Bérard, Lyon, France.
OBJECTIVES: To compare patient characteristics and first-line (1L) treatment patterns in metastatic non-small cell lung cancer (mNSCLC) in France and the United States (US) using the ESME and Flatiron Health datasets. This descriptive analysis aims to inform a data-driven transportability analysis by identifying key similarities and differences in real-world populations.
METHODS: Data from 25,529 patients in France and 41,082 in the US diagnosed with mNSCLC between 2015 and 2023 were analyzed. We summarized demographic, clinical, and biomarker characteristics at metastatic diagnosis or 1L initiation, and described 1L treatment patterns by histology and key biomarker status.
RESULTS: The French study population had a higher proportion of males (62.4% vs. 50.4% in the US) and, at 1L initiation, a younger age (65 years, IQR 58-72 vs. 69 years, IQR: 62-76) and a similar ECOG PS 0-1 (France: 70.5%, US: 72.3%). Non-squamous histology predominated in both cohorts (France: 84.4%, US: 78.4%) and most patients were diagnosed at de novo stage IV (France: 89.9%, US: 80.5%). PD-L1≥1% rates were similar (France: 60.3%, US: 61.8%). Biomarker positivity rates among non-squamous patients tested for the biomarker were close: ALK (France: 4.8%, US: 3.7%), EGFR (France: 17.8%, US: 20.0%), BRAF (France: 6.4%, US: 6.5%), and KRAS (France: 41.8%, US: 32.6%).However, 1L treatment patterns diverged: over half of French patients received platinum-based chemotherapy regardless of histology, while US patients more frequently received immunotherapy or targeted therapy.
CONCLUSIONS: Significant differences in sex, age, stage at diagnosis and treatment patterns exist between French and US study populations, while biomarker profiles and ECOG PS are similar. These findings are crucial for guiding population adjustment in transportability analyses of real-world outcomes between countries.
METHODS: Data from 25,529 patients in France and 41,082 in the US diagnosed with mNSCLC between 2015 and 2023 were analyzed. We summarized demographic, clinical, and biomarker characteristics at metastatic diagnosis or 1L initiation, and described 1L treatment patterns by histology and key biomarker status.
RESULTS: The French study population had a higher proportion of males (62.4% vs. 50.4% in the US) and, at 1L initiation, a younger age (65 years, IQR 58-72 vs. 69 years, IQR: 62-76) and a similar ECOG PS 0-1 (France: 70.5%, US: 72.3%). Non-squamous histology predominated in both cohorts (France: 84.4%, US: 78.4%) and most patients were diagnosed at de novo stage IV (France: 89.9%, US: 80.5%). PD-L1≥1% rates were similar (France: 60.3%, US: 61.8%). Biomarker positivity rates among non-squamous patients tested for the biomarker were close: ALK (France: 4.8%, US: 3.7%), EGFR (France: 17.8%, US: 20.0%), BRAF (France: 6.4%, US: 6.5%), and KRAS (France: 41.8%, US: 32.6%).However, 1L treatment patterns diverged: over half of French patients received platinum-based chemotherapy regardless of histology, while US patients more frequently received immunotherapy or targeted therapy.
CONCLUSIONS: Significant differences in sex, age, stage at diagnosis and treatment patterns exist between French and US study populations, while biomarker profiles and ECOG PS are similar. These findings are crucial for guiding population adjustment in transportability analyses of real-world outcomes between countries.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD56
Topic
Clinical Outcomes, Methodological & Statistical Research, Real World Data & Information Systems
Topic Subcategory
Reproducibility & Replicability
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology