KRAS Alterations in Advanced Non-Small Cell Lung Cancer (NSCLC): Temporal Trends in Testing Patterns and Targeted Treatment Use Across Europe Between 2018 and 2024
Author(s)
Jens Benn Sørensen, MD1, Avigayil Chalk, PhD2, Aine Madden, MSc2, Joseph Thomas, BSc2, Joana Jesus, MSc3, Mrudula B. Glassberg, PhD4, Adam Lee, MSc5, Caroline Rault, MSc6, Søren Paaske Johnsen, MD7.
1Department of Oncology, Rigshospitalet, Copenhagen, Denmark, 2IQVIA Ltd., London, United Kingdom, 3IQVIA Ltd., Porto Salvo, Portugal, 4Bristol Myers Squibb, Madison, NJ, USA, 5Bristol Myers Squibb, Uxbridge, United Kingdom, 6Data Gnosis, Rennes, France, 7Danish Center for Health Services Research, Aalborg University and Aalborg University Hospital, Gistrup, Denmark.
1Department of Oncology, Rigshospitalet, Copenhagen, Denmark, 2IQVIA Ltd., London, United Kingdom, 3IQVIA Ltd., Porto Salvo, Portugal, 4Bristol Myers Squibb, Madison, NJ, USA, 5Bristol Myers Squibb, Uxbridge, United Kingdom, 6Data Gnosis, Rennes, France, 7Danish Center for Health Services Research, Aalborg University and Aalborg University Hospital, Gistrup, Denmark.
OBJECTIVES: To investigate temporal trends in KRAS testing patterns and targeted treatment use among patients with advanced NSCLC in Europe.
METHODS: This cross-sectional analysis was based on the Oncology Dynamics database using data from sample populations of patients with drug-treated advanced NSCLC at centres in France, Germany, Italy, Spain, and the United Kingdom (UK), with data collected quarterly from Q3/2018 to Q3/2024. Projection methodology was used to estimate patient numbers/data at national levels for each country.
RESULTS: Sample patient numbers ranged from 12,945 (Spain) to 20,148 (Italy); projected numbers ranged from 114,269 (Spain) to 314,313 (Germany). Rates of testing for KRAS alterations increased over time in all countries (Q3/2018 range, 11% [Italy] to 64% [France]; Q3/2024 range, 51% [Spain] to 78% [Germany]). Among KRAS-tested patients, min-max KRAS-positivity rates between Q3/2018 and Q3/2024 were 12%-22% (France), 12%-17% (Germany), 7%-21% (Italy), 7%-18% (Spain), and 8%-18% (UK). Rates of testing for KRASG12C alterations in KRAS-positive patients also increased over time (Q3/2020 range, 27% [UK] to 100% [Italy]; Q3/2024 range, 47% [Germany] to 100% [Italy/Spain]). Among KRAS-positive patients, min-max KRASG12C-positivity rates between Q3/2020 and Q3/2024 were 49%-68% (France), 33%-68% (Germany), 34%-61% (Italy), 37%-56% (Spain), and 51%-74% (UK). The only clear temporal trend was a year-on-year increase in KRASG12C-positive patients in the UK. Anti-PD-(L)1 immunotherapy (alone/+other agents) was the most common first-line treatment for KRAS/KRASG12C-positive NSCLC across all countries through most of the study. However, use of single-agent targeted therapy in second/later-line settings increased over time following first approvals of KRAS-targeted therapy in 2022.
CONCLUSIONS: Data from this study suggest increased KRAS/KRASG12C testing across Europe and associated uptake of KRAS/KRASG12C-targeted therapy. However, there is a continued need to demonstrate the value of targeted treatment in patients carrying KRAS alterations to further encourage testing and drive continued investigation of new treatments for KRAS-positive advanced NSCLC.
METHODS: This cross-sectional analysis was based on the Oncology Dynamics database using data from sample populations of patients with drug-treated advanced NSCLC at centres in France, Germany, Italy, Spain, and the United Kingdom (UK), with data collected quarterly from Q3/2018 to Q3/2024. Projection methodology was used to estimate patient numbers/data at national levels for each country.
RESULTS: Sample patient numbers ranged from 12,945 (Spain) to 20,148 (Italy); projected numbers ranged from 114,269 (Spain) to 314,313 (Germany). Rates of testing for KRAS alterations increased over time in all countries (Q3/2018 range, 11% [Italy] to 64% [France]; Q3/2024 range, 51% [Spain] to 78% [Germany]). Among KRAS-tested patients, min-max KRAS-positivity rates between Q3/2018 and Q3/2024 were 12%-22% (France), 12%-17% (Germany), 7%-21% (Italy), 7%-18% (Spain), and 8%-18% (UK). Rates of testing for KRASG12C alterations in KRAS-positive patients also increased over time (Q3/2020 range, 27% [UK] to 100% [Italy]; Q3/2024 range, 47% [Germany] to 100% [Italy/Spain]). Among KRAS-positive patients, min-max KRASG12C-positivity rates between Q3/2020 and Q3/2024 were 49%-68% (France), 33%-68% (Germany), 34%-61% (Italy), 37%-56% (Spain), and 51%-74% (UK). The only clear temporal trend was a year-on-year increase in KRASG12C-positive patients in the UK. Anti-PD-(L)1 immunotherapy (alone/+other agents) was the most common first-line treatment for KRAS/KRASG12C-positive NSCLC across all countries through most of the study. However, use of single-agent targeted therapy in second/later-line settings increased over time following first approvals of KRAS-targeted therapy in 2022.
CONCLUSIONS: Data from this study suggest increased KRAS/KRASG12C testing across Europe and associated uptake of KRAS/KRASG12C-targeted therapy. However, there is a continued need to demonstrate the value of targeted treatment in patients carrying KRAS alterations to further encourage testing and drive continued investigation of new treatments for KRAS-positive advanced NSCLC.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH155
Topic
Epidemiology & Public Health, Real World Data & Information Systems, Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology