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    P01 - Antibody Drug Conjugates, Novel Therapeutics and Cytotoxics (ID 227)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Antibody Drug Conjugates, Novel Therapeutics and Cytotoxics
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P01.19 - Real-World Treatment Patterns in Treatment-Naïve Advanced NSCLC Patients in Asia: A Systematic Literature Review (ID 970)

      00:00 - 00:00  |  Presenting Author(s): Adam Lee

      • Abstract
      • Slides

      Introduction

      Clinical practice guidelines in Asia for the treatment of advanced NSCLC (aNSCLC) include a range of systemic therapy combinations administered according to patient and disease characteristics. As the treatment landscape evolves, it is relevant to understand what regimens are most common. This study aimed to characterize first line (1L) treatment patterns in real world (RW) settings in Japan, mainland China and Taiwan.

      Methods

      A systematic literature review (SLR) of RW observational studies was conducted using EMBASE and MEDLINE (January 2012 to September 2019), alongside searches of conference proceedings (2017 to 2019). Two reviewers assessed eligibility and included studies that described treatment patterns among treatment-naïve aNSCLC patients. Studies focusing exclusively on sub-populations, e.g. EGFR+ or ALK+, were excluded. Data regarding the study’s sampling frame, the type and frequency of therapies received were extracted and validated.

      Results

      Twenty-four studies were included (Japan=5; mainland China=16; Taiwan=3). About half (48%) were multi-centre, sample size varied from 30 to 16,413 patients, and study periods ranged from 2004 to 2017. The proportion of patients with EGFR+ was reported in one Japanese study (27%), one Taiwanese study (68%) and ranged from 21 to 52% across studies from mainland China.

      Eleven of the 24 studies were designed to capture all regimens used in 1L (Japan=5; mainland China=5; Taiwan=1). In the ten studies from mainland China and Japan, treatment predominantly consisted of chemotherapy-based regimens (Figure 1), except in one study restricted to elderly patients with performance status ≥ 2, in which chemo monotherapy (gemcitabine, vinorelbine, docetaxel) was most common. Tyrosine kinase inhibitor (TKI) use in Japan and mainland China was uncommon among squamous populations (≤3%) yet ranged up to 32% in non-squamous, and 41% in patients of mixed histology. The Taiwanese study reported that less than one-quarter of patients received platinum doublet therapy, reflecting the high prevalence of EGFR+ patients who received TKIs.

      Thirteen studies (mainland China=11; Taiwan=2) reported the relative frequency among pre-defined subsets of regimens (platinum-doublet-based (n=8), bevacizumab-based (n=3), rh-endostatin-based (n=1), immunotherapy-based (n=1)). In the latter study (from Taiwan), 28% of patients received immunotherapy monotherapy while 72% received immunotherapy plus chemotherapy.1 lot asia_6march2020.jpg

      Conclusion

      This SLR generated an encompassing overview of treatment patterns in 1L aNSCLC in Japan, mainland China and Taiwan, largely in the pre-immunotherapy era. The frequent use of TKIs reflects the high incidence of EGFR+ patients in Asia; early use of immunotherapy is starting to be captured in the most recent RW literature.

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