OBJECTIVES: To examine real-world treatment patterns and clinical characteristics of French patients with advanced (stage IIIb/IV) non-small cell lung cancer (NSCLC)

METHODS: Data were extracted from case report forms (CRFs) collected from physicians in France for patients with cancer in active phase in 2015. CRFs were extrapolated nationally using projection coefficients based on hospital activity level and type. This study was limited to treated, advanced NSCLC patients not participating in clinical trials.

RESULTS: Patients (n=39,188) were predominantly male (69.3%), mean age of 64.2 years, on first line treatment (63.3%), and with an Eastern Cooperative Oncology Group (ECOG) score of 1 (61.1%). Regardless of treatment line, patients were overwhelmingly treated with Chemotherapy/Targeted therapy/Immunotherapy (82.6%) without any other parallel treatment (e.g. surgery, radiotherapy). Platinums were prescribed in combination with at least one other product, typically with Pemetrexed (33.6%). Platinum combinations were preferred for first line (84.1%); while monotherapies were preferred for second and third+ line treatments (docetaxel = 32.3% and nivolumab = 24.9%, respectively). Among patients receiving monotherapy in any line, 30.5% patients experienced 3+ toxicities, with no toxicity reported in 73.4% of nivolumab patients. For combination therapy patients in any line, 38.1% experienced 3+ toxicities, with no toxicity reported in 37.9% of platinum+pemetrexed patients. Complete remission was reported in 2.7% of first line patients, 11.2% of second line patients and 2.3% of third+ line patients. Disease progression increased by treatment line, from 4.4% in first line to 13.6% in second line to 26.9% in third+ line. Due to ongoing treatment, response was not evaluated in 32.0% of patients.

CONCLUSIONS: : Given the toxicities and incomplete response associated with current treatments, there is still a need for safer, more effective treatment options in advanced NSCLC. The recent introduction of immunotherapies is promising.