Real-world treatment patterns and medical burden in patients with NSCLC: a retrospective database study in Japan

We investigated treatment patterns and healthcare resource utilization (HRU) to clarify unmet medical needs in second and later lines among Japanese patients with advanced non-small cell lung cancer (NSCLC).

This retrospective study included patients with NSCLC having first-line treatment from a claims database (January 2019-December 2024). Treatment patterns, time to treatment discontinuation (TTD), and HRU were described for patients with/without actionable genomic alteration (AGA) therapy.

Overall, 22,886 patients (with AGA, 7,831; without AGA, 15,055) were included. In patients with AGA, targeted therapy (48.6%), platinum doublet (12.1%), and chemo monotherapy (10.4%) were common second-line treatments, with median TTD 7.5, 4.3, and 3.0 months, respectively. In patients without AGA, chemo monotherapy (45.1%), ICI monotherapy (17.8%), and platinum doublet (13.9%) were the most prescribed second-line treatments with relatively short median TTD (2.7, 3.7, and 3.2 months, respectively). Hospitalization rates were higher in patients with second-line treatment duration <3 versus ≥3 months (incidence/100 person-years, 67-88 vs 35-38).

Treatment patterns were heterogeneous with short durations that were associated with higher rates of HRU. The study findings highlight the challenge of current treatments, and need for effective treatment options in clinical practice in Japan.