Real-World Treatment Patterns and Outcomes After Introduction of Immune Checkpoint Inhibitors (ICIs) in Patients With Advanced/Metastatic Non-Small Cell Lung Cancer (aNSCLC) in Europe (EU4+UK)

Author(s)

Slowley A¹, Kalilani L², Multani J³, Casey V⁴, Mpima S⁵, Yasuda M⁵, Chen CC⁵, Manuguid F⁴, Chao J⁶, Aziez A⁷, Bell K⁶, Stojadinovic A⁸
¹GSK, Brentford, UK, ²GSK, Research Triangle Park, NC, USA, ³IQVIA, Falls Church, VA, USA, ⁴IQVIA, London, UK, ⁵IQVIA, Plymouth Meeting, PA, USA, ⁶GSK, Upper Providence, PA, USA, ⁷GSK, Basel, Switzerland, ⁸GSK, Collegeville, PA, USA

Presentation Documents

ISPOREU22_Slowley.pdf

OBJECTIVES:

Real-world (RW) evidence can guide treatment decisions, including ICIs for aNSCLC. This study describes RW treatment patterns and clinical outcomes in aNSCLC in EU4 (France/Germany/Italy/Spain)+UK receiving pembrolizumab-based 1L maintenance therapy (1LMT).

METHODS:

This retrospective analysis of physician-completed chart reviews of patients treated in the preceding 12 months, collected Jul–Aug 2021, included patients ≥18 years with confirmed Stage IIIB/C‒IV aNSCLC without targetable driver alteration, ECOG status ≤1, partial/complete response (PR/CR) or stable disease (SD) after platinum-based 1L induction with pembrolizumab, and initiation of pembrolizumab-based 1LMT in EU4+UK. Duration of therapy (DOT), progression-free survival (PFS) and overall survival (OS) were evaluated overall and by country using Kaplan-Meier analysis.

RESULTS:

Of 322 patients, most were >65 years (57%), had ECOG=1 (77%), non-squamous (NSQ) histology (68%), Stage IV aNSCLC at diagnosis (92%), and no asymptomatic CNS/brain metastasis (aCNS mets [89%]). The most common 1LMT regimens were pembrolizumab monotherapy (76%) and pembrolizumab+pemetrexed (21%). Overall median (95% CI) DOT was 5.0 (3.9‒6.0) months. Overall median (95% CI) values for PFS and OS were 7.0 (6.0‒10.0) and 8.0 (7.0‒8.1) months, respectively; France/Germany/Italy/Spain/UK values were 5.0/10.1/7.0/7.0/7.0 and 5.0/9.0/8.0/8.0/7.0 months, respectively, in 61/60/73/67/61 patients. PFS was longer with PR/CR vs SD to 1LMT (10.0 vs 4.0 months; p<0.0001). OS was longer with PR/CR vs SD (9.0 vs 4.0 months; p<0.0001), NSQ vs squamous vs mixed aNSCLC (9.0 vs 6.0 vs 5.0 months; p=0.0045) and without vs with vs unknown aCNS mets (8.0 vs 3.0 vs 6.0 months; p<0.0001).

CONCLUSIONS:

These data suggest notable differences in clinical outcomes between subgroups and countries. Overall, improved survival outcomes were associated with PR/CR to 1LMT, aNSCLC and no aCNS mets. Awareness of between-country variability in clinical practice is critical for clinical trials. Studies with larger samples are needed.

Funding: GSK214794. Editorial support by Fishawack Health, funded by GSK.

Conference/Value in Health Info

2022-11, ISPOR Europe 2022, Vienna, Austria

Value in Health, Volume 25, Issue 12S (December 2022)

Code

HSD20

Disease

No Additional Disease & Conditions/Specialized Treatment Areas

Presentation