Clinical Value of Timely Targeted Therapy for Patients With Advanced Non-Small Cell Lung Cancer With Actionable Driver Oncogenes.

Autor:	Stricker T; Tennessee Oncology, Nashville, TN, USA.; OneOncology LLC, Nashville, TN, USA., Jain N; OneOncology LLC, Nashville, TN, USA., Ma E; Genentech, Inc., South San Francisco, CA, USA., Yu E; Genentech, Inc., South San Francisco, CA, USA., Wang R; Genentech, Inc., South San Francisco, CA, USA., Schuldt R; Genentech, Inc., South San Francisco, CA, USA., Price R; Genentech, Inc., South San Francisco, CA, USA., Szado T; Genentech, Inc., South San Francisco, CA, USA., Sussell J; Genentech, Inc., South San Francisco, CA, USA., Ogale S; Genentech, Inc., South San Francisco, CA, USA., Lin V; OneOncology LLC, Nashville, TN, USA.; Mary Bird Perkins Cancer Center, Baton Rouge, LA, USA., Arrowsmith E; Tennessee Oncology, Nashville, TN, USA.; OneOncology LLC, Nashville, TN, USA., Slater D; OneOncology LLC, Nashville, TN, USA.; Eastern Connecticut Hematology and Oncology, Norwich, CT, USA., Vaena D; OneOncology LLC, Nashville, TN, USA.; West Cancer Center & Research Institute, Germantown, TN, USA., Staszewski H; OneOncology LLC, Nashville, TN, USA.; New York Cancer & Blood Specialists, Port Jefferson Station, NY, USA., Fang B; OneOncology LLC, Nashville, TN, USA.; Astera Cancer Care, East Brunswick, NJ, USA., Seneviratne L; OneOncology LLC, Nashville, TN, USA.; Los Angeles Cancer Network, Los Angeles, CA, USA., Daniel D; Tennessee Oncology, Nashville, TN, USA.; OneOncology LLC, Nashville, TN, USA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Jun 03; Vol. 29 (6), pp. 534-542.
DOI:	10.1093/oncolo/oyae022
Abstrakt:	Background: A recent real-world study observed that 24% of patients with advanced non-small cell lung cancer (aNSCLC) with actionable driver oncogenes (ADOs) initiated nontargeted therapies before biomarker test results became available. This study assessed the clinical impact of the timing of first-line (1L) targeted therapies (TTs) in aNSCLC. Materials and Methods: This retrospective analysis of a nationwide electronic health record-derived deidentified database included patients aged ≥18 years diagnosed with aNSCLC with ADOs (ALK, BRAF, EGFR, RET, MET, ROS-1, and NTRK) from January 1, 2015, to October 18, 2022, by biomarker testing within 90 days after advanced diagnosis and received 1L treatment. Cohorts were defined by treatment patterns ≤42 days after test results: "Upfront TT" received 1L TT ≤42 days; "Switchers" initiated 1L non-TT before or after testing but switched to TT ≤42 days; and "Non-switchers" initiated non-TT before or after testing and did not switch at any time. Adjusted multivariate Cox regression evaluated real-world progression-free survival, real-world time to next treatment or death, and real-world overall survival. Results: A total of 3540 patients met the study criteria; 78% were treated in a community setting, and 50% underwent next-generation sequencing (NGS). There was no significant difference in outcomes between Switchers and Upfront TT; inferior outcomes were observed in Non-switchers versus Upfront TT. Conclusion: Our findings demonstrated improved outcomes with upfront 1L TT versus non-TT in patients with aNSCLC with ADOs and observed timely switching to TT after biomarker test result had similar outcomes to Upfront TT. Opportunities remain to improve the use of NGS for early ADO identification and determination of 1L TT. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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