Despite the approval of certain oral therapies for non-small cell lung cancer (NSCLC), the majority of patients with metastatic disease did not receive any systemic treatments from 2011 to 2015 (the years after their approval but prior to the approval of first-line immunotherapy).
Christopher R. Manz, of Harvard University, and colleagues presented data from their retrospective study examining the pre-immunotherapy era at AMCP 2021. The study included data from more than 27,000 patients with a new diagnosis of metastatic NSCLC in the SEER-Medicare database between January 2011 to December 2015.
According to their poster, oral therapies became available in 2011 for some patients with NSCLC with genetic alternations and resulted in marked improvement in survival. However, little is known about the treatment and survival patterns during the transition from oral therapies to the availability of immunotherapies.
The patients included were either untreated (66%), had intravenous chemotherapy (29%) or received an oral tyrosine kinase inhibitor (5%). Patients aged 80 or older were significantly less likely to receive any treatment. Of those patients who did get systemic therapy, use of oral therapies was three times higher in patients aged 66 to 69 years (OR=3.13; 95% CI, 2.56-3.84).
Median time to initiation of treatment was 58 days for both groups. Median time to next treatment was numerically higher in the oral TKI group compared with intravenous chemotherapy (8.8 vs. 4.9 months). Despite these advances, overall survival was poor. The median overall survival was 10.3 months for intravenous chemotherapy and 11.8 months for oral TKIs. Median overall survival for patients who were not treated was 2.8 months.
Manz CR, et al. Treatment patterns and survival among Medicare patients with metastatic non-small cell lung cancer: a pre-immunotherapy era baseline. Poster C4. Presented at AMCP 2021; April 12-16, 2021.