key: cord-0979183-f76wt7o5
authors: Bailey, H.; Lee, A.; Eccles, L.; Yuan, Y.; Last, M.; Burlison, H.; Forshaw, C.; Varol, N.
title: 104P Exploring the real-world impact of COVID-19 on first line (1L) treatment and management of EGFR-wild type (EGFR-WT) and ALK-wild type (ALK-WT) metastatic non-small cell lung cancer (mNSCLC) across Europe
date: 2021-12-31
journal: Annals of Oncology
DOI: 10.1016/j.annonc.2021.10.122
sha: 6d308d1c2a9c4e27c83f0493fcb5922c2f777ac7
doc_id: 979183
cord_uid: f76wt7o5

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Results: Pts mean age was 66.4 years in both cohorts and the majority were male (67.6% pre-COVID and 66.0% during COVID). A higher proportion of pts Dx during COVID were stage IVB (46.2%) than pre-COVID (37.6%). Effects of COVID on pt management were more frequently reported in the UK (79.7%) and least reported in Germany (19.6%). UK physicians changed prescribed treatment for 9.5% of pts due to COVID compared to 0.4% in Germany. The most commonly reported impact was moving to video/telephone consultations (20.0% Eu5) ranging from 0.4% (Germany) to 63.4% (UK), followed by reduced frequency of consultations (14.9% Eu5) ranging from 8.1% (France) to 22.2% (UK). Few effects of COVID-19 were reported for frequency of testing and monitoring of treatment. The proportion of pts prescribed 1L immunotherapy (IO) monotherapy and IO combination was higher in those Dx during COVID (30.1% and 34.0%, respectively) than pre-COVID (26.4% and 21.4% respectively).

Conclusions: According to current real-world data, COVID appeared to have greater impact on management of pts with EGFR-WT and ALK-WT mNSCLC in the UK than in Eu4. Pts Dx during COVID were Dx at a later stage and more commonly received 1L IObased therapies than those Dx pre-COVID. Although greater IO usage could be a result of an evolving treatment landscape, prescribed treatment had been changed for a small proportion of pts due to COVID. Further research is warranted to evaluate the impact these changes may have on pt outcomes. Background: The SOC for mNSQ NSCLC pts with no targetable genetic alterations is immunotherapy (IO) or platinum-based chemotherapy (CT) alone in 1L followed by the other in 2L or platinum-based CT and IO in 1L. SOC for pts with targetable genetic alterations (EGFR, ALK, ROS1) is one or more lines of tyrosine kinase inhibitors (TKIs). Data on optimal subsequent treatment after progression(s) on SOC are scarce.

Methods: This retrospective observational cohort study included mNSQ NSCLC treated pts aged 18 years (y) from the US ConcertAI Patient360 NSCLC (electronic medical record) database from 7/1/2016 to 12/31/2020 (index period), with follow-up until 3/31/2021 or death. Pts were grouped into 2 cohorts. Cohort 1: no targetable genetic alterations; treatment after IO and platinum-based CT progression. Cohort 2: targetable genetic alterations; treatment after TKI(s) progression. Objectives were to describe treatment patterns post SOC, clinical characteristics and real-world (rw) associations of clinical outcomes.

Results: Cohort 1 (N ¼ 270): Median age was 65 y, 12.2% were 75 y, 40.7% were female, 11.9% had 3 mets, 28.9% had recorded evidence of brain mets, 17.4% had ECOG status 2 and 9.6% were never smokers. Pts subsequently received docetaxel (doce) monotherapy (17.4%), doce + ramucirumab (ram; 32.6%) or other regimens (50.0%). The unadjusted median rw overall survival (rwOS) and progression free survival (rwPFS) were 6.3 and 2.7 months, respectively. Cohort 2 (N ¼ 104): Pts had genetic alterations in EGFR (97.1%), BRAF (6.7%), and ROS1 (4.8%). Median age was 64 y, 25.0% were 75 y, 68.3% were female, 28.8% had 3 mets, 43.3% had recorded evidence of brain mets, 11.5% had ECOG status 2 and 68.3% were never smokers. Pts subsequently received platinum-based CT (33.7%), IO + platinum-based CT (25.0%) or other regimens (41.3%). The unadjusted median rwOS and rwPFS were 9.9 and 3.1 months, respectively.

Conclusions: Doce + ram followed by doce monotherapy were common regimens in Cohort 1. Platinum-based CT + IO and platinum-based CT were more frequent in Cohort 2. Clinical outcomes of pts in both cohorts were poor after SOC, emphasizing unmet medical need.

Editorial acknowledgement: Editorial support was provided by Amanda Sheldon, PhD, inScience Communications (Philadelphia, PA, USA), funded by Sanofi.

Legal entity responsible for the study: Sanofi.

Funding: Sanofi.

Disclosure: H.A. Divan: Financial Interests, Personal, Full or part-time Employment: Sanofi Digital. A.

Full or part-time Employment: Sanofi; Financial Interests, Personal, Stocks/Shares: Sanofi. S. Gosset: Financial Interests, Personal, Full or part-time Employment: Sanofi Digital. D.P. Carbone: Financial Interests, Personal, Full or part-time Employment: The Ohio State University Comprehensive Cancer Center

Advisory Board: Daiichi Sankyo Inc.; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Advisory Board: EMD Serono/Merck; Financial Interests, Personal, Advisory Board: Flame Biosciences; Financial Interests, Personal, Advisory Role: Gritstone; Financial Interests, Personal, Advisory Board: GSK; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: Seattle Genetics

Honorariums : Bristol Myers Squibb; Financial Interests, Personal, Other, Consulting: Bristol Myers Squibb; Financial Interests, Personal, Other, Consulting: Bristol Myers Squibb KK; Financial Interests

Consulting: Genentech/Roche; Financial Interests, Personal, Other

Consulting: Mirati; Financial Interests, Personal, Other, Consulting: Novocure; Financial Interests, Personal, Other, Consulting: OncoCyte; Financial Interests, Personal, Other, Consulting: OncoHost; Financial Interests, Personal, Other, Consulting: Roche China; Financial Interests, Personal, Other, Consulting: Seattle Genetics

106P Real-world outcomes in extensive-stage small cell lung cancer with PD-L1 inhibitors in China

Clinical characteristics were summarized. The rwPFS was defined from the start of the treatment until the date of progression or death. Results: 247 ES-SCLC patients were included in this analysis. The median age was 62y and 189 (76.5%) were male. And different from previously report, 102 (41.3%) never smokers were found in this real-world setting. The top 3 metastasis sites at baseline were liver (33.6%), bone (27.5%) and brain (24.3%). 100 (40.5%) patients received PD-L1 plus chemotherapy and 147 (59.5%) patients only received standard chemotherapy. For the choice of chemo regimen, half of the patients (50.6%) were treated with cisplatin, and 61.1% of the pts received 6 cycles of chemotherapy. When combined with PD-L1, 71% pts received >4 cycles of chemotherapy

The OS results are not mature and are still in the follow-up. Conclusions: These results showed some distinct characteristics and treatment patterns of ES-SCLC patients in China, such as the smoking status