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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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 |
format | Article |
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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. 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.</description><identifier>ISSN: 0169-5002</identifier><identifier>EISSN: 1872-8332</identifier><identifier>DOI: 10.1016/j.lungcan.2018.12.003</identifier><identifier>PMID: 30642457</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>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</subject><ispartof>Lung cancer (Amsterdam, Netherlands), 2019-02, Vol.128, p.74-90</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-943cdeafbfdd74d0267f83a0cb8f60539bf126b99412d41ba8ee7cbc44c502713</citedby><cites>FETCH-LOGICAL-c365t-943cdeafbfdd74d0267f83a0cb8f60539bf126b99412d41ba8ee7cbc44c502713</cites><orcidid>0000-0003-4193-841X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.lungcan.2018.12.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30642457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horn, Leora</creatorcontrib><creatorcontrib>Bauml, Joshua</creatorcontrib><creatorcontrib>Forde, Patrick M.</creatorcontrib><creatorcontrib>Davis, Keith L.</creatorcontrib><creatorcontrib>Myall, Nathaniel J.</creatorcontrib><creatorcontrib>Sasane, Medha</creatorcontrib><creatorcontrib>Dalal, Anand</creatorcontrib><creatorcontrib>Culver, Ken</creatorcontrib><creatorcontrib>Wozniak, Antoinette J.</creatorcontrib><creatorcontrib>Baik, Christina S.</creatorcontrib><creatorcontrib>Mutebi, Alex</creatorcontrib><creatorcontrib>Zhang, Pingkuan</creatorcontrib><creatorcontrib>Wakelee, Heather A.</creatorcontrib><creatorcontrib>Johnson, Bruce E.</creatorcontrib><title>Real-world treatment patterns and survival of patients with BRAF V600-mutated metastatic non-small cell lung cancer</title><title>Lung cancer (Amsterdam, Netherlands)</title><addtitle>Lung Cancer</addtitle><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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomarkers, Tumor</subject><subject>BRAF</subject><subject>Carcinoma, Non-Small-Cell Lung - genetics</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - therapy</subject><subject>Clinical Decision-Making</subject><subject>Combined Modality Therapy</subject><subject>Cross-Sectional Studies</subject><subject>Disease Management</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - genetics</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Staging</subject><subject>Non-small cell lung cancer</subject><subject>Outcomes</subject><subject>Practice Patterns, Physicians</subject><subject>Prognosis</subject><subject>Proto-Oncogene Proteins B-raf - genetics</subject><subject>Real-world evidence</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0169-5002</issn><issn>1872-8332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1P3DAQhq2Kqiy0PwHkI5eEsZ3EyQlRxJeEhITaXi3HnoBX-VhsZxH_Hke75crFY8nPzLx-CDlhkDNg1fk67-fx2egx58DqnPEcQHwjK1ZLntVC8AOySlyTlQD8kByFsAZgkkHzgxwKqApelHJFwhPqPnubfG9p9KjjgGOkGx0j-jFQPVoaZr91W93TqVseXAICfXPxhf5-uryh_yqAbJijjmjpgFGHdHWGjtOYhUH3PTWYjiUtTXEN-p_ke6f7gL_29Zj8vbn-c3WXPTze3l9dPmRGVGXMmkIYi7prO2tlYYFXsquFBtPWXQWlaNqO8aptmoJxW7BW14jStKYoTAlcMnFMznZzN356nTFENbiwhNEjTnNQnMlGlBLEgpY71PgpBI-d2ng3aP-uGKjFt1qrvW-1-FaMq-Q79Z3uV8ztgPaz67_gBFzsAEwf3Tr0Kphk0KB1Hk1UdnJfrPgASCCVPg</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Horn, Leora</creator><creator>Bauml, Joshua</creator><creator>Forde, Patrick M.</creator><creator>Davis, Keith L.</creator><creator>Myall, Nathaniel J.</creator><creator>Sasane, Medha</creator><creator>Dalal, Anand</creator><creator>Culver, Ken</creator><creator>Wozniak, Antoinette J.</creator><creator>Baik, Christina S.</creator><creator>Mutebi, Alex</creator><creator>Zhang, Pingkuan</creator><creator>Wakelee, Heather A.</creator><creator>Johnson, Bruce E.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4193-841X</orcidid></search><sort><creationdate>201902</creationdate><title>Real-world treatment patterns and survival of patients with BRAF V600-mutated metastatic non-small cell lung cancer</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-943cdeafbfdd74d0267f83a0cb8f60539bf126b99412d41ba8ee7cbc44c502713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomarkers, Tumor</topic><topic>BRAF</topic><topic>Carcinoma, Non-Small-Cell Lung - genetics</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - therapy</topic><topic>Clinical Decision-Making</topic><topic>Combined Modality Therapy</topic><topic>Cross-Sectional Studies</topic><topic>Disease Management</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - genetics</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Neoplasm Metastasis</topic><topic>Neoplasm Staging</topic><topic>Non-small cell lung cancer</topic><topic>Outcomes</topic><topic>Practice Patterns, Physicians</topic><topic>Prognosis</topic><topic>Proto-Oncogene Proteins B-raf - genetics</topic><topic>Real-world evidence</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horn, Leora</creatorcontrib><creatorcontrib>Bauml, Joshua</creatorcontrib><creatorcontrib>Forde, Patrick M.</creatorcontrib><creatorcontrib>Davis, Keith L.</creatorcontrib><creatorcontrib>Myall, Nathaniel J.</creatorcontrib><creatorcontrib>Sasane, Medha</creatorcontrib><creatorcontrib>Dalal, Anand</creatorcontrib><creatorcontrib>Culver, Ken</creatorcontrib><creatorcontrib>Wozniak, Antoinette J.</creatorcontrib><creatorcontrib>Baik, Christina S.</creatorcontrib><creatorcontrib>Mutebi, Alex</creatorcontrib><creatorcontrib>Zhang, Pingkuan</creatorcontrib><creatorcontrib>Wakelee, Heather A.</creatorcontrib><creatorcontrib>Johnson, Bruce E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horn, Leora</au><au>Bauml, Joshua</au><au>Forde, Patrick M.</au><au>Davis, Keith L.</au><au>Myall, Nathaniel J.</au><au>Sasane, Medha</au><au>Dalal, Anand</au><au>Culver, Ken</au><au>Wozniak, Antoinette J.</au><au>Baik, Christina S.</au><au>Mutebi, Alex</au><au>Zhang, Pingkuan</au><au>Wakelee, Heather A.</au><au>Johnson, Bruce E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real-world treatment patterns and survival of patients with BRAF V600-mutated metastatic non-small cell lung cancer</atitle><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle><addtitle>Lung Cancer</addtitle><date>2019-02</date><risdate>2019</risdate><volume>128</volume><spage>74</spage><epage>90</epage><pages>74-90</pages><issn>0169-5002</issn><eissn>1872-8332</eissn><abstract>•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.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>30642457</pmid><doi>10.1016/j.lungcan.2018.12.003</doi><tpages>17</tpages><orcidid>https://orcid.org/0000-0003-4193-841X</orcidid></addata></record> |
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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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