Real-world study of PD-L1 testing patterns and treatment distribution in patients with metastatic non-small-cell lung cancer in Israel.

Abstract

Aim: We describe PD-L1testing patterns and first-linetreatment for patients with metastatic non-small-cell lung cancerin a 2.3million-member state-mandated health service in Israel. Materials & methods: Newly diagnosed stage IV non-small-cell lung cancer patients initiating systemic anticancer treatment from 1January 2017 until 31December 2018 were identified from the national cancer registry and Maccabi Healthcare Service database and followed until 30June 2019. Results: The cohort consisted of 410 patients; 58% males, median age 68years, 70% current/former smokers, 81% adenocarcinoma, 14% had brain metastases, and Eastern Cooperative Oncology Groupperformance status was 46/17/37% for 0-1/2-4/unknown, respectively. A total of 80%tested for PD-L1 expression, of which 47% had tumor proportion score (TPS) ≥50%. A total of95% with TPS≥ 50% and no known tumor aberrations (including EGFR mutations, and translocations in ALKand ROS1) received first-linePD-1/PD-L1-inhibitor monotherapy, and 80% of untested/TPS<50% received platinumdoublets. Conclusion: Fast uptake of testing was observed, and treatment patterns showed high adherence to guidelines.