Authors of a study, published in Lung Cancer, evaluated real-world data from US patients with metastatic non-squamous (mNSq) non-small cell lung cancer (NSCLC) that progressed on standard of care (SoC) in order to characterize follow-up treatment selections and clinical outcomes in this population.
According to the study’s lead author, Hozefa Divan, patients with mNSq NSCLC without driver mutations most commonly received docetaxel in later lines of therapy, while patients with mutations most commonly received one or more lines of tyrosine kinase inhibitors followed by platinum-based chemotherapy in later lines after SoC.
The investigators enrolled 400 US adult patients with mNSq NSCLC from the ConcertAI Patient360 NSCLC database who began treatment between 2016 and 2021. Participants were divided into those without (group 1) or with (group 2) suspected targetable EGFR, ALK, or ROS1 mutations.
All participants had 1 or more prior lines of therapy and progression on SoC. The primary outcomes of the analyses were real-world progression-free survival (rwPFS) and real-world overall survival (rwOS).
Most Common Follow-Up Treatments in NSCLC
Docetaxel (18.5%) or docetaxel plus ramucirumab (32.4%) were the most common follow-up treatments after progression on SoC in group 1. In group 2, authors noted most patients were treated with platinum-based doublet chemotherapy with (22.9%) or without (34.9%) immunotherapy.
Group 1 had a median rwPFS of 2.9 months and rwOS of 7.2 months, and group 2 had a median rwPFS and rwOS of 3.2 and 10.4 months, respectively. Of note, authors found that neither the adjunct treatment addition of ramucirumab in group 1 nor of immunotherapy in group 2 yielded any significant improvements in lung cancer survival.
Overall, Divan and colleagues described that patients with mNSq NSCLC with or without driver mutations typically received guideline-recommended treatments after progressing on SoC; however, “median survival was poor regardless of subsequent treatment, highlighting the need for more effective options,” they ended.