1120P Medical practice analysis of sex-specific trends in advanced non-small cell lung cancer (NSCLC) in biomarker testing and treatment in Europe and Asia

Abstract

Several papers have reported a trend of rising lung cancer incidence among women. In addition, sex has also been reported as a critical factor in lung cancer incidence and survival. To evaluate if there are sex-specific biomarkers and treatment approaches in advanced NSCLC, we studied the prevalence of biomarker testing rates and results for disease relevant mutations (EGFR, ALK, ROS1) and the corresponding treatment landscape. Anonymized patient-level data collected through a web-based survey between January and December 2021 from 16,062 NSCLC drug treated patients was analyzed, excluding clinical trials. The survey excluded any data captured in observational or interventional clinical studies, registries and real-world databases. The study collected real-world data in France, Germany, Italy, Spain, UK, China, Japan and South Korea. The percentage of biomarker tested women (w) and men (m) patients in Europe were as follows (w / m): EGFR (86% / 77%), ALK (83% / 75%) and ROS1 (69% / 61%). In Asia: EGFR (89% / 74%), ALK (70% / 61%) and ROS1 (54% / 46%). Out of the biomarker tested population, 38% of women were EGFR mutant, compared to 18% of men in Europe, while 66% of women were EGFR mutant and 39% of men in Asia. There were not different percentages of ALK and ROS1 mutations between sexes. The treatment approach for the mutated population presented significant differences among women and men. Women patients with EGFR mutant were more frequently treated with Osimertinib in Europe (67% / 59%) while the difference was not as marked in Asia (38% / 36%). Substantial sex differences were also observed in patients treated with Alectinib in Europe, (74% / 56%) and Asia (67% / 46%) for women and men, respectively. Likewise, ROS1 mutated women patients were more treated than men with Crizotinib in Europe (57% / 43%) and Asia (55% / 48%). Women were tested more frequently for all biomarkers and showed more EGFR mutations. Looking at the treatment approaches, a higher percentage of treatment with Osimertinib was found in Europe compared to Asia. There is sex-specific treatment management for patients with ALK and ROS1 mutations, where women received treatment with Alectinib and Crizotinib (respectively) more often than men.