2024 World Conference on Lung Cancer (WCLC) - Posters-P4.07F.01 Real World Characteristics and Distant Metastasis Free Survival of Patients with Early NSCLC Treated with Chemoimmunotherapy

P4.07F.01 Real World Characteristics and Distant Metastasis Free Survival of Patients with Early NSCLC Treated with Chemoimmunotherapy

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The study investigates the real-world effectiveness of chemoimmunotherapy (CIO) on patients with early-stage non-small cell lung cancer (eNSCLC) in the neoadjuvant (pre-surgery) and adjuvant (post-surgery) settings. Out of 279,183 NSCLC patients, 5,748 had stage II-IIIA eNSCLC and were selected for surgery, where 1,334 patients received CIO. The study primarily examines the real-world distant metastasis-free survival (rwDMFS) rates at 18 months, which were 80.2% for neoadjuvant and 83.0% for adjuvant therapy patients. It was noted that the risk of developing distant metastases was higher in patients with stage IIIA disease compared to those with stage II.<br /><br />There was an increase in CIO use in the neoadjuvant setting from 8.4% to 13.8%, and in the adjuvant setting from 19.7% to 22.6% from 2022 to 2023. The study also highlighted lower rates of biomarker testing in neoadjuvant patients compared to adjuvant patients.<br /><br />The research utilized data from the Flatiron Health Electronic Health Record (EHR) database, encompassing patient records from 280 cancer clinics. The outcomes were assessed using Kaplan Meier estimators, and hazard ratios were computed with Cox models, adjusting for factors like age, stage, and histology.<br /><br />The findings suggest that despite favorable rwDMFS, fewer than 30% of eligible patients received CIO in 2023, suggesting barriers to adoption remain. The study emphasizes the importance of real-world evidence in assessing new cancer treatment paradigms and indicates a need for greater engagement and understanding to overcome impediments to CIO adoption. Additionally, the patterns of metastatic disease distribution were similar across neoadjuvant and adjuvant settings, with frequent sites including bone, brain, and liver.

Asset Subtitle

Karen Schwed

Meta Tag

Speaker Karen Schwed

Topic Early-Stage NSCLC

Keywords

chemoimmunotherapy

non-small cell lung cancer

neoadjuvant therapy

adjuvant therapy

real-world effectiveness

distant metastasis-free survival

biomarker testing

Flatiron Health EHR

Kaplan Meier estimators

Cox models