Real-world treatment patterns and survival of patients with BRAF V600-mutated metastatic non-small cell lung cancer

•Limited real-world evidence exists on outcomes in BRAF-mutated NSCLC.•Survival in BRAF-mutated NSCLC patients may be longer than previously thought.•BRAFi/MEKi recipients had numerically longer OS versus usual care recipients.•Findings highlight potential value of BRAF/MEK-inhibiting agents as a th...

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Veröffentlicht in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2019-02, Vol.128, p.74-90
Hauptverfasser: Horn, Leora, Bauml, Joshua, Forde, Patrick M., Davis, Keith L., Myall, Nathaniel J., Sasane, Medha, Dalal, Anand, Culver, Ken, Wozniak, Antoinette J., Baik, Christina S., Mutebi, Alex, Zhang, Pingkuan, Wakelee, Heather A., Johnson, Bruce E.
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container_issue
container_start_page 74
container_title Lung cancer (Amsterdam, Netherlands)
container_volume 128
creator Horn, Leora
Bauml, Joshua
Forde, Patrick M.
Davis, Keith L.
Myall, Nathaniel J.
Sasane, Medha
Dalal, Anand
Culver, Ken
Wozniak, Antoinette J.
Baik, Christina S.
Mutebi, Alex
Zhang, Pingkuan
Wakelee, Heather A.
Johnson, Bruce E.
description •Limited real-world evidence exists on outcomes in BRAF-mutated NSCLC.•Survival in BRAF-mutated NSCLC patients may be longer than previously thought.•BRAFi/MEKi recipients had numerically longer OS versus usual care recipients.•Findings highlight potential value of BRAF/MEK-inhibiting agents as a therapy option.•Findings also highlight importance of BRAF testing to inform treatment decisions. Clinical outcomes data on BRAF-mutated non-small cell lung cancer (NSCLC) patients treated in routine practice is limited. To address this gap, we described treatment patterns and survival in a cohort of these patients evaluated/treated at 7 US academic cancer centers during 2009–2016. This was a retrospective chart review. Patients with BRAF V600-mutated metastatic NSCLC were selected. Current/previous participants in BRAF-related trials were excluded. Onset of metastatic NSCLC defined a patient’s index date, which had to occur ≥6 months before the chart review date. Analyses were descriptive, including Kaplan-Meier analyses for overall survival (OS). The study included 72 patients. At index, median age (range) was 65 (44–90) years; 61.1% were female. Fifty-two patients received ≥1 line of systemic therapy for metastatic disease. Platinum-based doublet chemotherapy was the most common first-line (1 L) regimen (76.9% of 1 l recipients); no patient received 1 l targeted therapy (TT) with a BRAF/MEK inhibitor. In total, 20 patients received TT in any treatment line (2 l or later). At time of review, 38 patients were deceased. Median (95%CI) OS from index for all patients was 31.0 (14.5, 63.8) months. Median (95%CI) OS was 56.5 (13.4, 89.1) months from index for TT recipients and 27.2 (10.6, 64.6) months in patients not treated with TT. Survival time in BRAF V600-mutated metastatic NSCLC patients studied here was higher than expected based on indirect comparisons with historical NSCLC cohorts for whom no oncogenic driver (BRAF or otherwise) was present. TT recipients had a numerically longer OS from metastatic onset than patients receiving usual care, further highlighting the importance of TT in BRAF V600-mutant NSCLC.
doi_str_mv 10.1016/j.lungcan.2018.12.003
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Clinical outcomes data on BRAF-mutated non-small cell lung cancer (NSCLC) patients treated in routine practice is limited. To address this gap, we described treatment patterns and survival in a cohort of these patients evaluated/treated at 7 US academic cancer centers during 2009–2016. This was a retrospective chart review. Patients with BRAF V600-mutated metastatic NSCLC were selected. Current/previous participants in BRAF-related trials were excluded. Onset of metastatic NSCLC defined a patient’s index date, which had to occur ≥6 months before the chart review date. Analyses were descriptive, including Kaplan-Meier analyses for overall survival (OS). The study included 72 patients. At index, median age (range) was 65 (44–90) years; 61.1% were female. Fifty-two patients received ≥1 line of systemic therapy for metastatic disease. Platinum-based doublet chemotherapy was the most common first-line (1 L) regimen (76.9% of 1 l recipients); no patient received 1 l targeted therapy (TT) with a BRAF/MEK inhibitor. In total, 20 patients received TT in any treatment line (2 l or later). At time of review, 38 patients were deceased. Median (95%CI) OS from index for all patients was 31.0 (14.5, 63.8) months. Median (95%CI) OS was 56.5 (13.4, 89.1) months from index for TT recipients and 27.2 (10.6, 64.6) months in patients not treated with TT. Survival time in BRAF V600-mutated metastatic NSCLC patients studied here was higher than expected based on indirect comparisons with historical NSCLC cohorts for whom no oncogenic driver (BRAF or otherwise) was present. 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Clinical outcomes data on BRAF-mutated non-small cell lung cancer (NSCLC) patients treated in routine practice is limited. To address this gap, we described treatment patterns and survival in a cohort of these patients evaluated/treated at 7 US academic cancer centers during 2009–2016. This was a retrospective chart review. Patients with BRAF V600-mutated metastatic NSCLC were selected. Current/previous participants in BRAF-related trials were excluded. Onset of metastatic NSCLC defined a patient’s index date, which had to occur ≥6 months before the chart review date. Analyses were descriptive, including Kaplan-Meier analyses for overall survival (OS). The study included 72 patients. At index, median age (range) was 65 (44–90) years; 61.1% were female. Fifty-two patients received ≥1 line of systemic therapy for metastatic disease. 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subjects Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
BRAF
Carcinoma, Non-Small-Cell Lung - genetics
Carcinoma, Non-Small-Cell Lung - mortality
Carcinoma, Non-Small-Cell Lung - pathology
Carcinoma, Non-Small-Cell Lung - therapy
Clinical Decision-Making
Combined Modality Therapy
Cross-Sectional Studies
Disease Management
Female
Humans
Lung Neoplasms - genetics
Lung Neoplasms - mortality
Lung Neoplasms - therapy
Male
Middle Aged
Mutation
Neoplasm Metastasis
Neoplasm Staging
Non-small cell lung cancer
Outcomes
Practice Patterns, Physicians
Prognosis
Proto-Oncogene Proteins B-raf - genetics
Real-world evidence
Retrospective Studies
Survival Analysis
Treatment Outcome
title Real-world treatment patterns and survival of patients with BRAF V600-mutated metastatic non-small cell lung cancer
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