Authors:
Background:The majority of patients with advanced non-sq NSCLC do not have high programmed death ligand 1 (PD-L1) expression or a targetable genetic alteration. Carbo-pem-bev is commonly used as first-line therapy in these patients, but it is unknown whether the addition of bev to carbo-pem improves overall survival (OS).Methods:Using nationally representative electronic health record data from Flatiron Health, we performed a retrospective cohort study of patients diagnosed with advanced non-sq NSCLC from 2011-2017 who received ≥1 cycle of carbo-pem, with/without bev, as initial systemic therapy for metastatic disease. Patients with alterations in epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) were excluded. The survival impact of adding bev to carbo-pem was assessed using a Cox proportional hazards model.Results:Patient characteristics are listed in Table 1 (n = 5,264). Median follow-up time and OS were 31 (IQR 16-49) and 10.2 (95% CI 9.8-10.8) months (mo), respectively. After adjusting for the covariates in Table 1, the addition of bev was associated with improved OS (median 12.1 vs 8.8 mo; HR 0.80, 95% CI 0.74-0.85, p < 0.001). In a sensitivity analysis of patients with known Eastern Cooperative Oncology Group Performance Status (ECOG PS) (N = 2,708), the effect of bev was similar (HR 0.79, 95% CI 0.72-0.88, p < 0.001).Conclusions:In this large, real-world dataset, the addition of bev to first-line carbo-pem for metastatic non-sq NSCLC was associated with improved OS. To our knowledge, this is the first study to address whether bev improves outcomes when added to carbo-pem.
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ASCO Annual Meeting