Summary
Several tyrosine kinase inhibitors (TKIs) targeting EGFR are approved for first-line (1L) treatment of EGFR MU NSCLC. Most pts progress on 1L EGFR TKIs and, unless they stay on current treatment or switch to other targeted therapy, will advance to receive systemic therapies. This study evaluated real-world treatment patterns and outcomes of pts with EGFR MU NSQ a/mNSCLC.
Methods
#VALUE!This retrospective observational study used pooled, de-identified EHR-derived data from US nationwide databases Flatiron Health, ConcertAI Patient360, and ConcertAI RWD360nlp. To exclude duplicate EHR, overlap assessment was performed via tokenization. EHR from pts diagnosed with EGFR MU NSQ a/mNSCLC between 2017–2022 who received earlier-line osimertinib (Osi), followed by 2L platinum-based chemotherapy, or 3L docetaxel (Doc) were included. Times from treatment line initiation until death (OS), within-line progression or death (PFS), treatment discontinuation (TTD), and initiation of next line or death (TTNTD) were assessed.
Results
Data from 256 pts were included: 227 (89%) in 2L and 29 (11%) in 3L. Median age at 2L/3L start was 67 (33–87) yr, 176 (69%) pts were female, 155 (61%) had ECOG PS of 0–1, and 225 (88%) had stage 3B or 4 NSCLC at diagnosis. Most common treatments were carboplatin + pemetrexed + pembrolizumab (39%) or carboplatin + pemetrexed (28%) in 2L, and Doc + ramucirumab (69%) or Doc mono (31%) in 3L. All 2L and 86% of 3L pts had received 1L Osi alone (2L: 68%; 3L: 52%) or Osi after older-generation EGFR TKI or a few rounds of chemotherapy ± IO (2L: 32%; 3L: 34%). Time-to-event outcomes are shown in the table.
Conclusions
#VALUE!RWE shows that 2L/3L treatment options for pts with EGFR MU NSQ a/mNSCLC are mostly limited to chemotherapy and are associated with poor outcomes, demonstrating a high unmet need for novel treatments.
