Real-world treatment and outcomes for EGFR WT advanced/metastatic non-squamous non-small cell lung cancer: pooled analysis from project LUMINATE-101.

Background: Lung cancer is the leading cause of cancer-related deaths in North America. Non-small cell lung cancer (NSCLC) is the most common type; most cases are advanced/metastatic at diagnosis. Available first and second lines of treatment include platinum-based chemotherapeutics, therapies targeting driver oncogene mutations, and immune checkpoint inhibitors, with limited options at later lines. Understanding the current treatment landscape to define unmet needs will benefit research and development of novel therapies for advanced/metastatic NSCLC.

Methods: The LUMINATE-101 retrospective cohort study evaluated real-world treatment patterns and outcomes for patients with non-squamous epidermal growth factor receptor (EGFR) wild type (WT) advanced/metastatic NSCLC diagnosed 1 January 2017 to 31 August 2022 that progressed on previous therapies. Patient data were pooled from US-based electronic health records-derived databases: Flatiron Health NSCLC real-world, ConcertAI Patient360 Lung Cancer, and ConcertAI RWD360NLP; redundant records were removed using tokenization.

Results: Overall, 620 patients were included; median age 67 years, >34% ECOG performance status ≥2, 19% had brain metastasis, 10% had liver metastasis, and 91% were current/ex-smokers. Most patients (54%) received a first-line platinum-based regimen ± immunotherapy and second-line docetaxel + ramucirumab/bevacizumab. Real-world outcomes included median overall survival (OS) = 6.4 months, median time to next treatment/death = 5.0 months, median time to treatment discontinuation = 2.3 months, and median progression-free survival = 3.5 months. ECOG performance status ≥2 correlated with poorer real-world outcomes overall; males had poorer survival and greater progression risk.

Conclusion: Real-world median OS of second-line patients on the current standard of care was < 7 months, highlighting an unmet need for more effective therapeutics in non-squamous EGFR WT advanced/metastatic NSCLC.