Summary
Docetaxel is recommended for patients (pts) with epidermal growth factor receptor (EGFR) wildtype (WT) non-squamous (NSQ) advanced/metastatic non-small cell lung cancer (a/mNSCLC) who progressed on or after platinum-based chemotherapy with/without immunotherapy (P-CT ± IO). Novel targeted therapies to improve outcomes for these pts are in development. This study assessed real-world outcomes of pts with a/mNSCLC receiving second- (2L) or third-line (3L) docetaxel.
Methods
Retrospective study of treatment patterns and outcomes using pooled, de-identified electronic health record (EHR)-derived data from 3 databases: the US nationwide Flatiron Health database, ConcertAI Patient360, and ConcertAI RWD360NLP. An overlap assessment was performed using tokenization to exclude duplicate EHR. Records from pts diagnosed with a/mNSCLC between 2017–2022, receiving docetaxel post-1L P-CT ± IO were included. Time-to-event outcomes were defined as time from treatment line initiation until events of death (OS), within-line progression or death (PFS), treatment discontinuation (TTD), and initiation of next line or death (TTNTD).
Results
EHR-derived data from 627 pts were included: 505 (81%) in 2L and 122 (19%) in 3L. Median age at 2L/3L initiation was 67 (35–88) yr, 55% of pts were male, 86% had stage 3B or 4 NSCLC at diagnosis, and 50% had ECOG performance status 0–1 at 2L/3L initiation. Treatment patterns for 1L/2L/(3L) were: 1) P-CT ± IO/docetaxel mono (27%); 2) P-CT ± IO/docetaxel + ramucirumab or bevacizumab (53%); 3) IO mono/P-CT ± IO/docetaxel mono or combo (6%); 4) P-CT ± IO/IO mono/docetaxel mono or combo (13%); and 5) non-EGFR TKI/P-CT ± IO/docetaxel mono or combo (1%). Time-to-event outcomes are presented in Table.
Conclusions
This analysis reveals real-world treatment patterns and exposes a high unmet need for novel treatments for pts with EGFR WT NSQ a/mNSCLC in the 2L/3L setting.
