Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Adoption of immuno-oncology in NSCLC, a real-world study in EU5.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20631)
Author(s): Alejandra Martinez De Pinillos, Isabel Ricote Lobera, Cristina Martinez, Caroline Anger, Filippo Guglielmetti, Roberto Jorge Bitton; IQVIA, London, United Kingdom; IQVIA, Madrid, Spain; IQVIA, Milan, Italy; IQVIA, Buenos Aires, Argentina
Background: To date, there are no robust studies in real world practice describing the use of IO (immuno-oncology) treatments in advanced/metastatic (adv/m) NSCLC. The available evidence in Europe is limited to observational studies of small size. This study aims to understand the impact of IO in adv/mNSCLC and study the profile of patients currently receiving these treatments. Methods: 20,157 cases of 1st and 2nd line adv/mNSCLC patients between October 2016 and September 2018 in EU5 (France, Germany, Spain, Italy, UK) were identified within Oncology Dynamics, an IQVIA oncology syndicated cross sectional survey collecting anonymized patient-level data. Patient profile was described, and two groups were created to assess differences in the use of IO treatments (nivolumab, pembrolizumab, atezolizumab, ipilimumab, durvalumab) across 2 time periods: #1 October 2016 - September 2017 (n = 9,310); #2 October 2017 - September 2018 (n = 10,847). Results: IO treatments increased 15% in 1st line adv/mNSCLC (13% in non-squamous and 23% in squamous histology) and 11% in 2nd line across periods; reaching treatment shares of 20.3% and 67.9% in 1st line and 2nd line in Period 2. Within IO-treated patients, 9.5% in 1st line and 13.6% in 2nd line had ECOG ≥2, and 27% were > 71 years old. The use of IO in 1st line patients without mutations (EGFR/ALK/ROS1/BRAF) increased by 24%, while standard chemotherapy decreased by 21%. Conclusions: IO treatments had a rapid adoption in Europe last year, influenced by its approval in 1st line adv/mNSCLC and by clinical guidelines recommendations. Ongoing clinical trials may suggest a growing trend in the future that could potentially impact in healthcare systems. In addition, real world patients treated with IO are older and have a worse performance status than those widely included in clinical trials. An evaluation of these results sheds light into IO treatments in NSCLC and may contribute to the design of real-world studies to generate new evidence and optimize the use of these class of drugs in clinical practice.
|adv/mNSCLC||Period 1 |
(n = 9,310)
|Period 2 |
(n = 10,847)
|n (%)||n (%)|
|IO in 1st line||369 (5.1)||1,703 (20.3)|
|Non-mutated||357 (4.9)||1,671 (19.9)|
|Mutated||12 (0.2)||32 (0.4)|
|Others in 1st line||6,856 (94,9)||6,674 (79.7)|
|IO in 2nd line||1,183 (56.7)||1,677 (67.9)|
|Non-mutated||1,157 (55.5)||1,635 (66.2)|
|Mutated||26 (1.2)||42 (1.7)|
|Others in 2nd line||902 (43.3)||793 (32.1)|