Related Experiment Video
Updated: Jun 23, 2025
Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Treatment Patterns and Clinical Outcomes Among Patients with Metastatic Non-small Cell Lung Cancer Without Actionable
Jerome H Goldschmidt1, Wan-Yu Tseng2, Yunfei Wang2
1Oncology and Hematology Associates of Southwest Virginia, US Oncology Research, Blacksburg, VA, USA.
Background:
For patients with metastatic non-small cell lung cancer, timely molecular testing is essential to determine the appropriate course of therapy. Initial treatment with platinum chemotherapy and/or an immune checkpoint inhibitor (ICI) is the standard of care for patients without actionable genomic alterations.
Objective:
We aimed to assess treatment patterns and clinical outcomes among patients with metastatic non-small cell lung cancer, no actionable genomic alterations, and with prior ICI and platinum-based chemotherapy in a community oncology setting.
Methods:
This retrospective observational study examined electronic health records from adult patients with an initial metastatic non-small cell lung cancer diagnosis without actionable genomic alterations from 2017 to 2019. Patients had received a subsequent line of therapy (LOT) [index] after discontinuing platinum-based chemotherapy plus an ICI in the previous one or two LOTs. Patient demographics and clinical characteristics were analyzed descriptively. Clinical outcomes were evaluated using Kaplan-Meier analyses.
Results:
Among the study population (n = 961), the most common index LOT regimens were non-platinum-based chemotherapies (57.3%), platinum-based chemotherapies (12.9%), ICI-based chemotherapies (12.7%), platinum + ICI-based chemotherapies (9.4%), and other (7.7%). The most common post-index LOT regimens were non-platinum based (61.2%), ICI based (15.3%), platinum based (10.7%), platinum + ICI based (3.2%), and other (2.5%). Median time to treatment discontinuation, time to next treatment, and overall survival were numerically longest with index LOT ICI-based regimens (6.5, 9.9, and 18.9 months, respectively) and shortest with platinum-based regimens (2.8, 5.3, and 8.0 months, respectively) and non-platinum-based regimens (2.6, 5.0, and 7.8 months, respectively).
Conclusions:
Among patients with metastatic non-small cell lung cancer without actionable genomic alterations previously treated with platinum + ICIs, non-platinum chemotherapy agents were most commonly prescribed in the index LOT. Clinical outcomes including time to treatment discontinuation, time to next treatment, and overall survival were short, highlighting the unmet need for more effective later-line treatments.
Insights
For metastatic non-small cell lung cancer patients without actionable genomic alterations, subsequent treatments after platinum and immune checkpoint inhibitor (ICI) therapy showed limited clinical benefit. This highlights an unmet need for more effective later-line therapies in this population.
Area of Science:
- Oncology
- Medical Oncology
- Translational Research
Background:
- Metastatic non-small cell lung cancer (NSCLC) requires timely molecular testing for optimal treatment selection.
- Standard first-line therapy for NSCLC without actionable genomic alterations involves platinum chemotherapy and/or immune checkpoint inhibitors (ICIs).
Purpose of the Study:
- To evaluate treatment patterns and clinical outcomes in metastatic NSCLC patients with no actionable genomic alterations.
- To analyze outcomes after prior treatment with platinum-based chemotherapy and ICIs in a community oncology setting.
Main Methods:
- Retrospective observational study of electronic health records (2017-2019).
- Included adult patients with metastatic NSCLC, no actionable genomic alterations, and prior platinum/ICI treatment.
- Analyzed demographics, clinical characteristics, and outcomes (time to treatment discontinuation, time to next treatment, overall survival) using Kaplan-Meier analysis.
Main Results:
- Non-platinum chemotherapy was the most common index line of therapy (LOT) (57.3%) for 961 patients.
- ICI-based regimens showed numerically longer median survival (18.9 months) compared to platinum-based (8.0 months) or non-platinum-based regimens (7.8 months).
- Overall clinical outcomes were short across all evaluated regimens, indicating limited efficacy.
Conclusions:
- Non-platinum chemotherapy agents are frequently used as the index LOT after platinum and ICI treatment in metastatic NSCLC.
- Short clinical outcomes underscore a significant unmet need for improved later-line therapies for NSCLC patients.
- Further research into novel therapeutic strategies is crucial for this patient population.
More Related Videos
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
07:42Patient-Derived Tumor Explants As a "Live" Preclinical Platform for Predicting Drug Resistance in Patients
Published on: February 7, 2021
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
01:27Tumor Immunotherapy