(056) Examination of treatment patterns amongst drug classes in metastatic non-small cell lung cancer patients across EU4, UK, and US

Background: OncoLocator™ is a comprehensive database of contemporary (2022-2023) patient charts spanning various oncology indications and can be a good source of data for cross-sectional assessments of drug utilization. We used it to explore treatment patterns in metastatic non-small cell lung cancer (mNSCLC) across different countries.

Objectives: To describe treatment patterns in mNSCLC patients in France, Germany, Italy, Spain, UK, and USA during the years 2022 and 2023.

Methods: Patients with mNSCLC (ALK/EGFR negative, adenocarcinoma subtype) were identified from OncoLocator™ between 2022-2023. Data related to the type of systemic therapy received (chemotherapy, immunotherapy (IO), others), line of treatment (1L, 2L), and the country were extracted and analyzed. A trained medical oncologist classified all treatments.

Results: A total of 2,876 (2022: n=1,682; 2023: n=1,194) patients with mNSCLC were identified from OncoLocator™. In 2022, 84.1% of patients (n=377) received chemotherapy as an adjuvant treatment. Chemotherapy was most frequently used in France (23.7%), Italy (21.5%), and Spain (18.3%) and less frequently used in in Germany (10.4%) although its use increased to 21.1% in 2023. Rates of adjuvant chemotherapy in other countries were similar in 2022 and 2023.
The use of IO as adjuvant therapy in 2022 (n=51) varied across countries, with highest rates observed for France (27.5%) and lowest for Italy (2.0%) and UK (9.8%). In 2023 (n=35), increases in IO use were observed for Italy (11.4%) and the UK (17.1%). Other therapies were used infrequently as an adjuvant treatment (2022: 2.4%; 2023: 5.3%).
In both time periods, the use of IO was the most common 1L therapy (2022: 624/712 [87.6%]; 2023: 399/482 [82.8%]). Germany (9.8%) and the US (11.7%) had the lowest use of IO as 1L in 2022. However, IO use as 1L increased in 2023 in Germany to 17.3% whereas it decreased to 4.0% in the US. A reduction in 1L chemotherapy was observed between 2022 and 2023 for France (10.4% to 5.1%), Italy (36.4% to 18.6%), and Spain (19.5% to 8.5%). Although the use of other therapies as a 1L increased between 2022 and 2023 (from 1.5% to 5.0%), no clear pattern was determined between countries.
The use of chemotherapy and IO as a 2L modality were similar across time and countries. Other therapies were used more often as a 2L than 1L treatment, with highest use overall observed in the UK (2022: 23.0%; 2023: 30.5%) and Germany (2022: 16.7%; 2023: 26.8%).

Conclusions: This study confirms the heterogeneity of mNSCLC treatment patterns across countries. The observed variations reveal the need for further exploration of prescriber patterns to enhance understanding and address differences in treatment approaches across countries.