Impact of immune checkpoint inhibitors on the management of locally advanced or metastatic non-small cell lung cancer in real-life practice in patients initiating treatment between 2015 and 2018 in France and Germany
Menée entre 2015 et 2018 en Allemagne et en France dans un contexte de vie réelle à partir de données portant sur un total de 10 405 patients atteints d'un cancer du poumon non à petites cellules de stade localement avancé ou métastatique, cette étude rétrospective évalue l'efficacité, du point de vue de la survie globale, des inhibiteurs de point de contrôle immunitaire en traitement de première ligne
Objectives : To describe the impact of immune checkpoint inhibitors (ICIs) on treatment patterns and survival outcomes in patients with locally advanced or metastatic non-small celllung cancer (aNSCLC) in France and Germany. Materials and Methods : Patients with aNSCLC without known ALK or EGFR mutations receiving first-line (1L) therapy were included from (i) the retrospectiveEpidemiological-Strategy and Medical Economics Advanced and Metastatic Lung Cancercohort (ESME-AMLC, France; 2015–2018) and (ii) the prospective Clinical Research platformInto molecular testing, treatment and outcome of non-Small cell lung carcinoma Patientsplatform (CRISP, Germany; 2016–2018). Analyses were stratified according to histology.Survival outcomes were estimated using Kaplan–Meier methodology and stratified byyear of 1L therapy. Data sources were analysed separately. Results : In ESME-AMLC and CRISP, 8,046 and 2,359 patients were included in the study, respectively.In both countries, approximately 20% of all patients received pembrolizumab monotherapyas 1L treatment in 2018. In ESME-AMLC, the proportion receiving an ICI over the courseof treatment (any line) increased from 42.2% (2015) to 56.1% (2018) in patients withsquamous histology, and 28.9% to 51.9% with non-squamous/other; in CRISP, it increasedfrom 50.6% (2016) to 65.2% (2018) with squamous histology, and 40.8% to 62.7% withnon-squamous/other. Two-year overall survival from 1L initiation was 36.8% and 25.6%in the squamous cohorts and 36.5% and 30.8% in the non-squamous/other cohorts in ESME-AMLCand CRISP, respectively. No significant change in overall survival was observed overtime; however, the follow-up time available was limited in the later years of theanalysis. Conclusion : The results of this joint research from two large clinical databases in France and Germany demonstrate the growing use of ICIs in the management of aNSCLC. Future analyseswill allow for the evaluation of the impact of ICIs on long-term survival of patients with a NSCLC.
Lung Cancer 2022