REAL-WORLD TRENDS AND INTER-HOSPITAL VARIATION IN FIRST-LINE TREATMENT AND TIME TO NEXT TREATMENT IN METASTATIC NSCLC
Author(s)
Gabriela Ojeda1, Jasper Deuring, MD2, Elena Fernández, MD3, Maria Angeles Sala, MD3, Irune Loizagadiaz, MD3, Begoña Campos, MD4, Ana Lopez, MD5, Maria Jimenez, MD5, Montserrat Chao, MD5, Aitor Azkarate, MD6, Clara Martorell, MD6, Victor Marchetta, MD2, Jon Zugazagoitia, MD7, Antonio Calles, MD8, Luis Puente, MD8, Delvys Rodriguez, MD9.
1LOGEX B.V., Valencia, Spain, 2LOGEX B.V., Amsterdam, Netherlands, 3Hospital Universitario Basurto, Bilbao, Spain, 4Hospital Universitario Lucus Augusti, Lugo, Spain, 5Hospital Universitario Severo Ochoa, Madrid, Spain, 6Hospital Univeristario Son Espases, Palma de Mallorca, Spain, 7Hospital Universitario 12 Octubre, Madrid, Spain, 8Hospital General Universitario Gregorio Marañón, Madrid, Spain, 9Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
1LOGEX B.V., Valencia, Spain, 2LOGEX B.V., Amsterdam, Netherlands, 3Hospital Universitario Basurto, Bilbao, Spain, 4Hospital Universitario Lucus Augusti, Lugo, Spain, 5Hospital Universitario Severo Ochoa, Madrid, Spain, 6Hospital Univeristario Son Espases, Palma de Mallorca, Spain, 7Hospital Universitario 12 Octubre, Madrid, Spain, 8Hospital General Universitario Gregorio Marañón, Madrid, Spain, 9Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
OBJECTIVES: To evaluate the temporal evolution of first-line (1L) treatments and real‑world outcomes (time to next treatment, TTNT) in patients with metastatic stage IV non-small cell lung cancer (NSCLC) treated across six hospitals.
METHODS: A multicenter retrospective observational study was conducted in six Spanish hospitals, including patients with stage IV NSCLC who initiated 1L therapy between 2019-2023, using clinical registry data. Annual trends in the use of chemotherapy (CT) monotherapy, immunotherapy (IO), CT+IO combinations, targeted therapies (TTs), and others were analyzed, along with the number of treatment lines per patient and treatment pathways (Sankey diagrams). TTNT was estimated using Kaplan-Meier methods (medians and 95% confidence intervals [95% CI]).
RESULTS: A total of 1,639 patients were included. From 2019 to 2023, the proportion of CT monotherapy decreased from 65% to 18.8%, while CT+IO reached 55.6% in 2023 and IO-monotherapy remains at 15.9% in 2023 in the multicenter aggregate. Median TTNT (95% CI) was 5.7 months (5.2-6.3) with CT alone, 5.8 (5.1-6.6) with CT+IO, 6.4 (5.6-8.2) with IO monotherapy, and 7.9 (6.2-9.6) with TKIs. Substantial variability was observed across hospitals in 1L patterns: the share of CT+IO among 1L patients ranged approximately 26% to 41%, while TT usage varied from 5% to 16% of 1L therapies. The median TTNT varied between 4.0 months and 7.7 months.
CONCLUSIONS: The rapid uptake of IO in 1L and the longer TTNT observed with TTs suggest early adaptation of the selected therapeutic options. Inter-hospital variability highlights opportunities to harmonize 1L treatment practices and underscores the value of real‑world evidence for healthcare decision‑making.
METHODS: A multicenter retrospective observational study was conducted in six Spanish hospitals, including patients with stage IV NSCLC who initiated 1L therapy between 2019-2023, using clinical registry data. Annual trends in the use of chemotherapy (CT) monotherapy, immunotherapy (IO), CT+IO combinations, targeted therapies (TTs), and others were analyzed, along with the number of treatment lines per patient and treatment pathways (Sankey diagrams). TTNT was estimated using Kaplan-Meier methods (medians and 95% confidence intervals [95% CI]).
RESULTS: A total of 1,639 patients were included. From 2019 to 2023, the proportion of CT monotherapy decreased from 65% to 18.8%, while CT+IO reached 55.6% in 2023 and IO-monotherapy remains at 15.9% in 2023 in the multicenter aggregate. Median TTNT (95% CI) was 5.7 months (5.2-6.3) with CT alone, 5.8 (5.1-6.6) with CT+IO, 6.4 (5.6-8.2) with IO monotherapy, and 7.9 (6.2-9.6) with TKIs. Substantial variability was observed across hospitals in 1L patterns: the share of CT+IO among 1L patients ranged approximately 26% to 41%, while TT usage varied from 5% to 16% of 1L therapies. The median TTNT varied between 4.0 months and 7.7 months.
CONCLUSIONS: The rapid uptake of IO in 1L and the longer TTNT observed with TTs suggest early adaptation of the selected therapeutic options. Inter-hospital variability highlights opportunities to harmonize 1L treatment practices and underscores the value of real‑world evidence for healthcare decision‑making.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD54
Topic
Clinical Outcomes, Organizational Practices, Real World Data & Information Systems
Topic Subcategory
Reproducibility & Replicability
Disease
Oncology