Overview
Programmed death ligand 1 (PD-[L]1) inhibitors, such as retifanlimab, have improved survival for many patients with metastatic non-small cell lung cancer (mNSCLC), however, they may be underutilized. This study investigated treatment patterns and factors associated with selection of a PD-(L)1 inhibitor as first-line (1L) treatment among patients with mNSCLC who were not candidates for targeted therapies.
Using the Flatiron Health EHR-derived Panoramic database comprised of >280K patients with NSCLC, researchers identified a cohort of 13,000 eligible patients with mNSCLC and found that 25% of patients did not receive a PD-(L)1 inhibitor in the 1L setting, a trend that remained consistent from 2019 to 2023. The study identified several factors associated with the likelihood of receiving a PD-(L)1 inhibitor, including age, ethnicity, smoking status, year of metastatic diagnosis, prior PD-(L)1 treatment, PD-(L)1 staining status, stage at initial NSCLC diagnosis, practice type, and geographic region.
Why this matters
Despite strong evidence and clinical guidelines recommending PD-(L)1 inhibitors as the preferred first-line therapy for mNSCLC, a significant portion of patients are not receiving these treatments. This research highlights ongoing gaps in the adoption of immunotherapy and suggests that both clinical and structural factors—such as patient demographics, disease characteristics, and healthcare setting—play a role in treatment decisions. Understanding these dynamics is crucial for ensuring that all eligible patients have access to the most effective therapies, ultimately aiming to improve outcomes for people with mNSCLC.