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Background:This retrospective study described treatment patterns of pts with RDP using ram, ICIs, or chemo in the US. As RDP pts (progression ≤ 12 weeks after Pt start) in REVEL benefited from ram/docetaxel, outcomes were analyzed for pts treated with ram after RDP on 1L/2L Pt.Methods:aNSCLC pts receiving ram, ICI or chemo in 2L or 3L between March 2015 - May 2017 after Pt, with ≥ 3 months of potential follow-up, were identified in the Flatiron Health EHR-derived database. Overall survival (OS) was indexed to 1L start and real-world progression-free survival (rwPFS) was indexed to start of 2L/3L ram. Unadjusted hazard ratios (HR) were calculated using Cox models.Results:Of 591 eligible pts, 105 (18%) had RDP on Pt, of whom 48%, 24%, and 28% were treated with ram, ICIs, or chemo, respectively. Table shows baseline factors and treatment patterns for RDP pts. RDP pts more often used ram in 2L. Ram pts with RDP were younger and more likely had non-squamous NSCLC, stage IV at diagnosis, and 2+ ECOG status than pts without RDP. For ram pts, RDP was associated with shorter median OS (12.66 v 17.51 months; HR = 0.56, 95% CI: 0.36 - 0.87). Median rwPFS was similar between ram pts with RDP (reference) and those without RDP (2.9 v 3.0 months; HR = 1.25, 95% CI: 0.83 - 1.91).Conclusions:In this real-world cohort, pts with RDP on Pt were more often treated with ram than ICIs or chemo. This differential use suggests that RDP may influence the choice of subsequent therapy. In ram pts, RDP correlated with poorer OS as seen in REVEL, further suggesting RDP as a potential negative prognostic factor for OS. Further research on RDP risk factors and optimal treatment sequence is urgently needed given the poor clinical outcomes.
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ASCO Annual Meeting