Treatment Pattern and Overall Survival of Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicentric Real-World Study in China (CTONG1506)

Background: CTONG1506, an observational study assessed the real-world treatment patterns and overall survival (OS) of Chinese advanced non-squamous non-small cell lung cancer (NSCLC) patients in current treatment practices. Methods: Patients initiated with 1st line therapy were identified from 12 tertiary hospitals across China. Survival data were collected 1- and 2-years after study initiation. OS was estimated using the Kaplan-Meier method. Results: Among 540 patients with survival data, median OS was 21.4 months (95% CI: 18.1–25.5), and 2-year OS rate was 46.3% (95% CI: 42.0%-51.0%). Median OS for patients with epidermal growth factor receptor (EGFR +) mutation (n = 203), anaplastic lymphoma kinase ( ALK +) rearrangement (n = 24), EGFR-/ALK - were 27.9 months (95% CI: 23.4-NA), 24.5 months (95% CI: 18.1-NA), and 15.7 (95% CI: 13.1–21.1) months, respectively. Median OS was not reached in EGFR exon 19 deletion patients compared to EGFR exon 21 L858R mutation patients (21.4 months, 95% CI: 16.7–35.6, P = 0.038). 93 EGFR +  patients received tyrosine kinase inhibitor (TKI) alone, 21 received chemotherapy alone and 66 received TKI and chemotherapy [median OS 25.5 months, 18.1 months, and 35.6 months, respectively]. For EGFR +  patients, TKI alone was the preferred therapy in 1st (58.2%) and 2nd (56.8%) line when compared to chemotherapy (35.1% and 31.1% respectively). In 3rd line, chemotherapy was preferred (46.0%) over TKI only (38.0%) in these patients. Conclusions: OS for patients with advanced non-squamous NSCLC patients aligned with previous trials. EGFR +  patients who received both TKI and chemotherapy had longer median OS, which is consistent with results from other trials.