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This summary is machine-generated.

First-line maintenance treatment (1LMT) in advanced/metastatic non-small cell lung cancer (a/mNSCLC) improved progression-free survival and maintained overall survival. Adding pemetrexed to immuno-oncology (IO) did not enhance outcomes and increased adverse events in non-squamous histology.

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Area of Science:

  • Oncology
  • Immunotherapy
  • Pharmacology

Background:

  • First-line maintenance treatment (1LMT) options, including immuno-oncology (IO) agents and pemetrexed, are approved for advanced/metastatic non-small cell lung cancer (a/mNSCLC).
  • Real-world data on treatment patterns and outcomes for patients with a/mNSCLC lacking targetable mutations are crucial for optimizing therapy.

Purpose of the Study:

  • To assess real-world treatment patterns and outcomes in patients with a/mNSCLC receiving 1LMT.
  • To compare the efficacy and safety of different 1LMT strategies, including the addition of pemetrexed to IO.

Main Methods:

  • International retrospective chart review of adult patients with a/mNSCLC.
  • Propensity score weighting was used to compare outcomes between patients who received 1LMT and those who did not.
  • Specific analysis of adding pemetrexed to IO-containing 1LMT in patients with non-squamous/mixed histology.

Main Results:

  • 1LMT was associated with significantly longer progression-free survival (PFS) (17.7 vs 7.1 months) and similar overall survival (OS) (31.7 vs 31.0 months) compared to no 1LMT.
  • In non-squamous/mixed histology, patients receiving IO only had longer time to treatment discontinuation, PFS, and OS than those receiving IO plus pemetrexed.
  • Patients receiving IO plus pemetrexed experienced higher rates of fatigue and anemia.

Conclusions:

  • First-line maintenance treatment (1LMT) improves PFS and maintains OS in a/mNSCLC without significantly increasing healthcare resource utilization.
  • Adding pemetrexed to 1LMT with IO did not provide additional clinical benefit in non-squamous/mixed histology and was associated with more adverse events.
  • There is a need for novel 1LMT options to further enhance clinical outcomes in a/mNSCLC.