911 Improved lifelines needed for all lines: real-world treatment patterns and attrition rates in US patients with non-driver mutation metastatic non-small cell lung cancer

BackgroundImmunotherapy with PD-(L)1-based strategies has rapidly transformed the treatment landscape for non-driver mutation metastatic non-small cell lung cancer (NSCLC). However, it is unclear how recent immunotherapy approvals have translated into real world practice patterns and patient outcomes. This study examined treatment patterns and attrition rates by line of therapy (LOT) among real-world patients with non-driver mutation metastatic NSCLC in the era of immunotherapy.MethodsIn this retrospective analysis, adult patients with metastatic NSCLC (2015–2022) and at least one LOT were identified from COTA’s US multi-center NSCLC database of curated longitudinal electronic health records. Patients receiving tyrosine kinase inhibitors or with confirmed EGFR/ALK abnormalities were excluded.ResultsAmong the 2,107 patients identified, the median age at diagnosis was 69 years, with 45.9% female (table 1) and median follow-up time of 11.9 months. PD-(L)1-based therapy was the most common frontline therapy (55.7%), of which 60.5% was PD-(L)1/platinum combo (figure 1). The use of frontline platinum chemotherapy (without PD-(L)1) decreased from 76.8% in 2015 to