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Patient Characteristics, Testing and Treatment Patterns, and Outcomes in EGFR-Mutated Advanced Non-Small Cell Lung
Cliff Molife1, Katherine B Winfree2, Hollie Bailey3
1Value, Evidence, and Outcomes-Oncology, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA. molife_cliff@lilly.com.
Introduction:
Treatment landscape for advanced/metastatic NSCLC (aNSCLC) has evolved considerably over the past few decades with the advent of targeted therapies for epidermal growth factor receptor-mutated (EGFRm+) aNSCLC treatment. This study described real-world patient and disease characteristics, treatment and practice patterns, and clinical, economic, and patient-reported outcomes (PROs) in patients with EGFRm+ aNSCLC.
Methods:
Data were derived from the Adelphi NSCLC Disease Specific Programme™ (DSP™), a point-in-time survey conducted between July and December 2020. The survey included oncologists and pulmonologists, and their consulting patients (with physician-confirmed EGFRm+ aNSCLC) from nine countries: the US, Brazil, the UK, Italy, France, Spain, Germany, Japan, and Taiwan. All analyses were descriptive.
Results:
Overall, 542 physicians reported data for 2857 patients (mean age 65.6 years), and most patients were female (56.0%), white (61.0%), and had stage IV disease at initial diagnosis (76.0%), and adenocarcinoma histology (89.0%). Most patients received EGFR-tyrosine kinase inhibitors (TKI) therapy in first- (91.0%), second- (74.0%), and third-line (67.0%). The most common tumor samples and methods for EGFR detection were EGFR-specific mutation detection tests (44.0%) and core needle biopsy (56.0%). Median time to next treatment was 14.0 (IQR 8.0-22.0) months and disease progression was the main physician-reported reason for early discontinuation. The most common physician-reported disease symptoms were cough (51.0%), fatigue (37.0%), and dyspnea (33.0%). In patients assessed for PROs, mean EQ-5D-5L index and FACT-L health utility scores were 0.71 and 83.5, respectively. On average, patients lost 10.6 h of work/week for approximately 29.2 weeks due to EGFRm+ aNSCLC.
Conclusion:
This real-world multinational data set showed that most patients with EGFRm+ aNSCLC were treated per the country relevant clinical guidelines, with progression as the main reason for early treatment discontinuation. For the included countries, these findings may offer a useful benchmark for decision makers to determine future allocation of healthcare resources for patients with EGFRm+ aNSCLC.
Insights
This study analyzed real-world data from patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC). Findings highlight treatment patterns and outcomes, informing healthcare resource allocation for EGFRm+ NSCLC.
Area of Science:
- Oncology
- Pulmonology
- Pharmacoeconomics
Background:
- The treatment landscape for advanced/metastatic non-small cell lung cancer (NSCLC) has significantly evolved with targeted therapies.
- Epidermal growth factor receptor-mutated (EGFRm+) NSCLC has specific targeted treatment options.
- Real-world data is crucial for understanding patient characteristics and treatment patterns.
Purpose of the Study:
- To describe real-world patient and disease characteristics in EGFRm+ aNSCLC.
- To outline current treatment and practice patterns for EGFRm+ aNSCLC.
- To evaluate clinical, economic, and patient-reported outcomes (PROs) in EGFRm+ aNSCLC.
Main Methods:
- Data collected via the Adelphi NSCLC Disease Specific Programme™ (DSP™) survey (July-December 2020).
- Included oncologists, pulmonologists, and their patients with physician-confirmed EGFRm+ aNSCLC from nine countries.
- Descriptive analyses of patient demographics, disease characteristics, and treatment data.
Main Results:
- 542 physicians reported on 2857 patients; most were female, white, stage IV, and had adenocarcinoma.
- EGFR-tyrosine kinase inhibitors (TKI) were widely used in first-, second-, and third-line settings (91%, 74%, 67%).
- Disease progression was the primary reason for treatment discontinuation; patients reported significant work loss due to the disease.
Conclusions:
- Real-world data indicate EGFRm+ aNSCLC patients are treated according to guidelines, with progression driving treatment changes.
- Findings provide a benchmark for healthcare resource allocation decisions for EGFRm+ aNSCLC.
- Understanding real-world outcomes is essential for optimizing care pathways.
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