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Catherine McGuiness
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-09 - Real-World Brigatinib Use in Non-Small Cell Lung Cancer Patients with Prior Use of Crizotinib/Other ALK Therapies in the US (ID 1403)
10:15 - 18:15 | Author(s): Catherine McGuiness
- Abstract
Background
Anaplastic lymphoma kinase (ALK) gene rearrangements occur in 3 to 8% of non-small cell lung cancer (NSCLC) cases. Targeted therapy options for ALK+ NSCLC patients have increased recently and are associated with improved survival. This study aimed to describe the real-world use of brigatinib, particularly after crizotinib and other ALK-tyrosine kinase inhibitors (TKI), where most brigatinib patients were found in this study.
Method
Adult (≥18 years) patients with ≥ 1 claim for brigatinib (index claim) after crizotinib were identified between 01-Jan-2011 and 30-Jun-2018 from IQVIA’s US-based Longitudinal Patient-Centric Pharmacy Claims Database. Patients had ≥ 6 months of observation before crizotinib and were continuously followed post-index for use of brigatinib and until discontinuation (≥ 90-day gap in brigatinib therapy, switch to another ALK-TKI therapy, or the end of follow-up of brigatinib). Brigatinib on-treatment rates at 6- and 12-months post-index were estimated using Kaplan-Meier analysis in subgroups with > 50 patients.
Result
The final sample consisted of 92 post-crizotinib brigatinib patients, most of whom were treated with crizotinib and ≥ 1 second generation (2G) ALK-TKI inhibitor (n=72); twenty patients received crizotinib only prior to brigatinib. Among the 72 patients treated with crizotinib and ≥ 1 2G ALK-TKI median (range) age at brigatinib initiation was 58.1 (30-85) years; 68.1% of the sample was female and most had third party insurance (51.4%). Mean (SD) post-index follow-up time was 6.7 (4.2) months. Sixty patients (56.9%) received crizotinib and alectinib (± ceritinib), while twelve (16.7%) received only crizotinib and ceritinib prior to brigatinib. Median brigatinib treatment duration was 8.3 months in patients with prior crizotinib and ≥ 1 2G ALK-TKI (n=72) ; 64.8% and 49.3% of these patients were still on brigatinib 6- and 12- months after initiation. In the subgroup of patients with crizotinib and alectinib ± (ceritinib) prior to brigatinib (n=60), median duration of brigatinib treatment was also 8.3 months; 66.6% and 48.1% were still on brigatinib 6- and 12-months after initiation.
Conclusion
This US-based real-world study provides early insight into the use of recently approved brigatinib in NCSLC in the post crizotinib setting. These results indicate that use of brigatinib may be associated with potential clinical benefit with patients staying on therapy for a significant duration of time post a 2G ALK-TKI inhibitor. The duration of brigatinib in earlier lines remains to be investigated in future studies when larger sample sizes are available.
