P3.15-30 Treatment Patterns and Survival of Patients with Stage IV Non-Small Cell Lung Cancer (NSCLC) in the Era of Novel Therapies

Abstract

Treatment strategies for metastatic non-small cell lung cancer (NSCLC) are evolving rapidly. Real–world evidence (RWE) of treatment patterns and outcomes can further our understanding of the impact of novel therapies. In this population-based study, we investigated treatments and outcomes for stage IV NSCLC in a large Canadian province. Patients diagnosed with de novostage IV NSCLC from April 1st2010 to March 31st2015 were identified. Baseline characteristics, treatments, and outcomes were analyzed. We classified treatments targeting EGFR, EML4–ALK, and ROS1 as targeted therapy and intravenous checkpoint inhibitors as immunotherapy. A total of 6,438 patients were identified with NSCLC, of whom 3,606 (56%) had de novostage IV disease. The median age of diagnosis was 69 years (range 20–100) and 52.4% were male. The median age among those who received targeted therapy and immunotherapy were 63 (27–90) and 61 (37–72) years, respectively, and 41.8% and 61.8% were male, respectively. First line treatments were: 5.7% targeted agents (n= 204), 1% immunotherapy (n = 1), 19.5% palliative chemotherapy (n= 703), 6.8% palliative radiotherapy (n= 246), and 74.8% received supportive care only (n= 2,698). Most frequent subsequent treatments in 2L included: 30.7% targeted agents (n= 125), 1.7% immunotherapies (n= 7), 67.6% palliative chemotherapy (n= 275), 32.2% palliative radiotherapy (n= 131). Median overall survival (mOS) for the whole cohort was 3.8 months (0–not reached [NR]). MOS with targeted therapies was 18 months (1.4–NR), chemotherapy was 9.4 months (1.1–NR) and supportive care only had a mOS of 2.5 months (0–NR) (Figure 1). About 1.0% of patients (n= 34) received immunotherapy at any line. Survival benefit was dependent on type of treatment received, with a trend towards improved survival with newer agents.