Treatment Patterns, Outcomes in Second-line Advanced NSCLC Treated After Prior Platinum Chemotherapy/IO Combination Therapy

IO in combination with platinum chemotherapy has become the standard of care (SOC) for first-line treatment of patients with advanced NSCLC. Although there are limited second-line treatment options for patients who have progressed on first-line platinum chemotherapy/IO combination therapy, real-world data are limited. Results of a study that evaluated second-line treatment patterns and clinical outcomes in the United States were presented at the 2023 North America Conference on Lung Cancer.

The study consisted of 539 patients with advanced NSCLC who progressed on first-line platinum chemotherapy/IO treatment and were grouped according to second-line treatment category, including taxane monotherapy and combination therapy and nontaxane monotherapy, and by second-line treatment: docetaxel monotherapy, docetaxel plus ramucirumab combination therapy, and gemcitabine monotherapy. The median age at second-line treatment was 68 years, and 78% had nonsquamous histology. The researchers assessed OS, TTD, and time to next treatment (TTNT) using Kaplan-Meier methods from the start of second-line treatment.

Results showed that the majority of patients received docetaxel plus ramucirumab combination therapy (45.1%), followed by docetaxel monotherapy (18.9%) and gemcitabine monotherapy (14.1%). The researchers found median OS to be comparable across the three treatments. Median TTD and TTNT outcomes were also comparable across the three treatments. Patients with fewer (≤4 vs ³8) administrations of prior IO treatment (median OS, 5.0 months vs 7.8 months) and ECOG PS ³2 versus 0-1 (median OS, 4.5 months vs 6.8 months) had significantly shorter survival on second-line treatment.

“This study describes the limited treatment options and the poor prognosis of patients with advanced NSCLC in the real world who are treated with the current standard of care treatments in [the second line] after prior [first-line] platinum chemotherapy/IO combination therapy, emphasizing the need for new treatments in this setting,” the researchers concluded.

Source: Daniel D, Mhatre SK, Carroll C, Patel R, Park J, Haggstrom D. Treatment patterns and outcomes in second-line advanced NSCLC treated after prior platinum chemotherapy and immunotherapy combination therapy: a real-world study. Abstract of a poster presented at the 2023 North America Conference on Lung Cancer; December 1-3, 2023; Chicago, Illinois.