Physician Perspectives on Unmet Need and Treatment Options Among Patients With Relapsed Advanced Nonsquamous Non-Small Cell Lung Cancer (NSCLC) in Canada: Findings From Qualitative Interviews
Author(s)
Katherine M. Osenenko, MCPM1, Cassandra DEBARD, MSc, MPH1, Rana Qadeer, MSc2, Martin Rupp, PharmD, PhD2, Suzanne McMullen, MHA1, Tracey D'Cunha, PhD2, Geoffrey Liu, MSc, MD3.
1Broadstreet HEOR, Vancouver, BC, Canada, 2AstraZeneca Canada, Mississauga, ON, Canada, 3Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
1Broadstreet HEOR, Vancouver, BC, Canada, 2AstraZeneca Canada, Mississauga, ON, Canada, 3Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
OBJECTIVES: In Canada, docetaxel remains the primary treatment for advanced non-small cell lung cancer (NSCLC) progressing after platinum-based chemotherapy (PBC). We aimed to understand physician perspectives on unmet need and treatment options in this patient population.
METHODS: Semi-structured videoconference interviews were conducted among five medical oncologists across Canadian provinces. Questions focused on experience and perspectives regarding treatment decision-making in the post-PBC setting, usage of docetaxel, and treatment gaps.
RESULTS: Physicians reported survival and health-related quality of life (HRQoL) as key treatment goals. HRQoL was described as a driver in patient decision-making, with most patients valuing functionality and ability to participate in daily activities. Decision-making regarding treatment eligibility and treatment with docetaxel was multi-faceted and typically physician-led; key factors that impacted decision-making included ECOG status, comorbidities, response to and toxicities with prior treatments, and individual patient preferences. For patients with actionable genomic alterations (AGAs, e.g., EGFR), who tend to be younger, patient age also influences treatment decisions. Although younger patients with AGAs may be more motivated to pursue additional lines of therapy, physicians reported that the patients’ expectations are often unmet due to the generally poor benefit-risk profile of docetaxel. Across the broad relapsed advanced NSCLC population, docetaxel was characterized by modest survival, low response rates, and a challenging toxicity profile (especially fatigue, peripheral neuropathy, pain, and myalgias). As such, not all treatment-eligible patients receive docetaxel, either due to patient preference or physician discretion. To manage docetaxel-related toxicities and mitigate HRQoL impacts, all physicians reported using reduced docetaxel dosing (<75mg/m2) for a subset of patients at treatment initiation or during early cycles, with variability in dosing practices.
CONCLUSIONS: These qualitative findings revealed limitations of docetaxel in this patient population, underscoring the need for more effective and better-tolerated alternatives that optimize HRQoL. These qualitative findings will guide a quantitative survey among Canadian medical oncologists.
METHODS: Semi-structured videoconference interviews were conducted among five medical oncologists across Canadian provinces. Questions focused on experience and perspectives regarding treatment decision-making in the post-PBC setting, usage of docetaxel, and treatment gaps.
RESULTS: Physicians reported survival and health-related quality of life (HRQoL) as key treatment goals. HRQoL was described as a driver in patient decision-making, with most patients valuing functionality and ability to participate in daily activities. Decision-making regarding treatment eligibility and treatment with docetaxel was multi-faceted and typically physician-led; key factors that impacted decision-making included ECOG status, comorbidities, response to and toxicities with prior treatments, and individual patient preferences. For patients with actionable genomic alterations (AGAs, e.g., EGFR), who tend to be younger, patient age also influences treatment decisions. Although younger patients with AGAs may be more motivated to pursue additional lines of therapy, physicians reported that the patients’ expectations are often unmet due to the generally poor benefit-risk profile of docetaxel. Across the broad relapsed advanced NSCLC population, docetaxel was characterized by modest survival, low response rates, and a challenging toxicity profile (especially fatigue, peripheral neuropathy, pain, and myalgias). As such, not all treatment-eligible patients receive docetaxel, either due to patient preference or physician discretion. To manage docetaxel-related toxicities and mitigate HRQoL impacts, all physicians reported using reduced docetaxel dosing (<75mg/m2) for a subset of patients at treatment initiation or during early cycles, with variability in dosing practices.
CONCLUSIONS: These qualitative findings revealed limitations of docetaxel in this patient population, underscoring the need for more effective and better-tolerated alternatives that optimize HRQoL. These qualitative findings will guide a quantitative survey among Canadian medical oncologists.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD88
Topic
Health Service Delivery & Process of Care
Disease
Oncology