Real-World Study of PD-L1 Testing Patterns and Treatment Distribution in Patients with Metastatic Non-Small-Cell Lung Cancer in Israel

Abstract

Aim: We describe PD-L1 testing patterns and first-line treatment for patients with metastatic non-small-cell lung cancer in a 2.3 million-member state-mandated health service in Israel. Materials & methods: Newly diagnosed stage IV non-small-cell lung cancer patients initiating systemic anticancer treatment from 1 January 2017 until 31 December 2018 were identified from the national cancer registry and Maccabi Healthcare Service database and followed until 30 June 2019. Results: The cohort consisted of 410 patients; 58% males, median age 68 years, 70% current/former smokers, 81% adenocarcinoma, 14% had brain metastases, and Eastern Cooperative Oncology Group performance status was 46/17/37% for 0–1/2–4/unknown, respectively. A total of 80% tested for PD-L1 expression, of which 47% had tumor proportion score (TPS) ≥ 50%. A total of 95% with TPS ≥ 50% and no known tumor aberrations (including EGFR mutations, and translocations in ALK and ROS1) received first-line PD-1/PD-L1-inhibitor monotherapy, and 80% of untested/TPS < 50% received platinum doublets. Conclusion: Fast uptake of testing was observed, and treatment patterns showed high adherence to guidelines.

Clinical Outcomes of Patients with HER2 Positive Metastatic Breast Cancer to the Brain, with First-Line Trastuzumab, Pertuzumab and Chemotherapy, in a Real-World Setting

“…The discontinuation of treatment was determined by any of the following criteria: the commencement of the next line of therapy (second-line), death while still on treatment, or a lapse of at least 120 days between the last drug administration and the follow-up date. [29][30][31] Patients that did not discontinue were censored at the last purchase date. Overall survival was evaluated by utilizing data on all-cause mortality obtained monthly from the National Insurance Institute in Israel and was defined as the duration from the initiation of the first-line treatment to the date of death from any cause.…”