Girard Nicolas, Xu Qingqing, Camidge D Ross, Baijal Shobhit, Ng Sophia, Kamalakar Rajesh, Ratajczak Christine, Alhasani Hasan, Crawford Samuel, Karve Sudeep, Lu Shun
Département d'Oncologie Médicale, Institut Curie, 75005 Paris, France.
AbbVie, Inc., North Chicago, IL 60064, United States.
Oncologist. 2025 May 8;30(5). doi: 10.1093/oncolo/oyaf029.
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.
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.
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.
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.
肺癌是北美癌症相关死亡的主要原因。非小细胞肺癌（NSCLC）是最常见的类型；大多数病例在诊断时已处于晚期/转移性阶段。可用的一线和二线治疗包括铂类化疗药物、针对驱动癌基因突变的疗法以及免疫检查点抑制剂，而后续治疗线的选择有限。了解当前的治疗格局以确定未满足的需求将有助于晚期/转移性NSCLC新型疗法的研发。
LUMINATE - 101回顾性队列研究评估了2017年1月1日至2022年8月31日期间诊断为非鳞状表皮生长因子受体（EGFR）野生型（WT）晚期/转移性NSCLC且在先前治疗中病情进展的患者的真实世界治疗模式和结局。患者数据来自美国基于电子健康记录的数据库：Flatiron Health NSCLC真实世界数据库、ConcertAI Patient360肺癌数据库和ConcertAI RWD360NLP；使用词元化去除冗余记录。
总体而言，共纳入620例患者；中位年龄67岁，超过34%的东部肿瘤协作组（ECOG）体能状态≥2，19%有脑转移，10%有肝转移，91%为现吸烟者/既往吸烟者。大多数患者（54%）接受了一线铂类方案±免疫治疗以及二线多西他赛+雷莫西尤单抗/贝伐单抗。真实世界结局包括中位总生存期（OS）=6.4个月，中位下次治疗/死亡时间=5.0个月，中位治疗中断时间=2.3个月，中位无进展生存期=3.5个月。ECOG体能状态≥2总体上与较差的真实世界结局相关；男性生存率较低且进展风险更高。
按照当前护理标准，二线患者的真实世界中位OS<7个月，这突出表明非鳞状EGFR WT晚期/转移性NSCLC对更有效治疗方法存在未满足的需求。
