Treatment (tx) characteristics of patients (pts) with locally advanced or metastatic non-small cell lung cancer (NSCLC) receiving atezolizumab (atezo) monotherapy in US clinical practice
Authors: M. Frueh, O.E. Rahma, R.K. Pachynski, J. Mazieres, J. Goldschmidt, T.G.N. Ton, S.K. Mhatre, C.-Y. Chuo, J. Martinalbo, J. Davies, R. Juergens
Journal: Annals of Oncology (2019)

Background: In the randomised Ph III OAK study, atezo (anti–PD-L1) significantly improved survival vs docetaxel, regardless of PD-L1 levels, and was approved by the FDA and EMA as 2L+ tx for advanced NSCLC. Given limited real-world data (RWD) on atezo in clinical practice, we describe here tx and characteristics of pts receiving atezo in clinical practice. Methods: Pts diagnosed with advanced NSCLC on or after Jan 1, 2011, and who initiated 2L+ atezo before Jul 1, 2017, were identified from the Flatiron Health database of electronic health records from US-based hospitals and community practices. Time-on-treatment (TOT) was defined as time from first to last atezo dose, plus 1 cycle. Median TOT was calculated using the Kaplan-Meier methods. Data from the OAK registrational trial (NCT02008227) are provided. Results: 122 pts met selection criteria (Table). 105 pts (86%) had 2L+ atezo without prior anti–PD-1 tx, while 17 pts (14%) had prior anti–PD-1 tx. Median TOT was 3.9 mo (95% CI: 2.9, 4.9), similar to OAK. A median of 4 cycles was administered for both non-squamous (IQR 1-22) and squamous (IQR 1-17) histology. Progression was the most common reason for atezo discontinuation.Table179P Pt characteristics and atezo tx in US clinical practice and a global registration trialRWDOAKaRittmeyer, 2017Pts, n122425Age, median (range), y69 (34-84)63 (33-82)Male, n (%)59 (48)261 (61)White race, n (%)86 (71)302 (71)Non-squamous histology, n (%)92 (75)313 (74)EGFR positive, n (%)8 (7)42 (10)ALK positive, n (%)2 (2)2 (< 1)ECOG PS > 1, n (%)11 (12)b0Smoking history, n (%)102 (84)341 (80)Tested for PD-L1, n (%)58 (48)425 (100) Evidence of PD-L1 expression, n (%)22 (51)b% calculated from non-missing results241 (57)Previous lines of therapy (advanced setting), n (%) 168 (56)320 (75) 227 (22)105 (25) ≥ 327 (22)0Median TOT (range), mo3.9 (0.1-16)3.4 (0-26)cBased on 609 safety-evaluable pts using uncensored methods (Rittmeyer, 2017)a Rittmeyer, 2017b % calculated from non-missing resultsc Based on 609 safety-evaluable pts using uncensored methods (Rittmeyer, 2017) Open table in a new tab Conclusions: TOT with atezo in the US RW setting was similar to the OAK clinical trial setting, although pts treated in RW were older and 22% had ≥ 3 lines of previous therapy. Editorial acknowledgement: Medical writing assistance for this abstract was provided by Steffen Biechele, PhD, of Health Interactions and funded by F. Hoffmann-La Roche, Ltd. Legal entity responsible for the study: F. Hoffmann-La Roche, Ltd. Funding: F. Hoffmann-La Roche, Ltd. Disclosure: M. Frueh: Consulting/advisory: BMS, MSD, AZ, BI, Roche; Research funding: MSD. O.E. Rahma: Advisory board: Celgene, Leerink, PRMA Couns., Outcomes4me, Puretech; Consulting: Alcimed SAS, GFK, Merck, Five Prime, Defined Health Honorarium: Merck, Clinical Care Option, Mi Bioresearch, Alaunusglobal; Other (study/editorial support): Roche. R.K. Pachynski: Grants/research support: Ferring, Janssen; Consultant: AZ, BMS, EMD Serono, Exelixis, Dendreon, Jounce, Pfizer; Speakers: AZ, GNE/Roche, Dendreon, Genomic Health, Sanofi, Merck; Other (support of parent study and funding of editorial support): Roche. J. Mazieres: Financial relationship: Roche, BMS, MSD, AstraZeneca, Pfizer, Novartis: consulting fees; Contracted research: Roche, BMS. J. Goldschmidt Jr.: Consulting/advisory role/honorarium: Amgen; Speakers bureau: BMS, Celgene; Support of parent study, funding of editorial support: Roche. T.G.N. Ton: Full time employee with self-managed stock: Genentech/Roche. S.K. Mhatre: Genentech, Inc./F. Hoffmann-La Roche: full time employee F. Hoffmann-La Roche: Stock shareholder (self managed) C-Y. Chuo: Full time employee, stock, support of parent study, funding of editorial support: Roche/Genentech. J. Martinalbo, J. Davies: Full time employee: F. Hoffmann-La Roche. R. Juergens: Honoraria: Amgen, AZ, BI, BMS, Lilly, Merck Sharp & Dohme, Roche Canada; Consulting or advisory role: Amgen, AZ, BI, BMS, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche Canada; Research funding: AZ/MedImmune, BMS, Merck Sharp & Dohme, Novartis.