HSR22-130: A Retrospective Cohort Study of Selpercatinib-Treated Patients With Advanced/Metastatic Non-Small Cell Lung Cancer: Preliminary Findings From a Real-World Database in the United States

Authors: Naleen Raj Bhandari PhD1, Elizabeth Hadden MPH, MSN, RN2, Patrick M Peterson PhD1, Ana Sofia Afonso PhD3, and Scott S Barker PharmD1
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  • 1 Eli Lilly and Company, Indianapolis, IN
  • | 2 DeLisle & Associates, Ltd, Indianapolis, IN
  • | 3 Eli Lilly B.V., Utrecht, the Netherlands

Background: Selpercatinib, a highly selective and potent REarranged during Transfection (RET) inhibitor, is approved for RET-altered lung or thyroid cancer treatment in multiple countries. Selpercatinib was the first RET inhibitor approved in the United States (US) on 08 May 2020. This study described demographic, disease, and treatment characteristics, treatment patterns, and preliminary outcomes data (time to treatment discontinuation [TTD], overall survival [OS]) in selpercatinib-treated US patients with advanced/metastatic NSCLC (a/mNSCLC). Methods: This retrospective, descriptive cohort study used the nationwide Flatiron Health electronic health record-derived de-identified database of patients with a/mNSCLC. Patients were included if they initiated selpercatinib-based treatments between 08 May 2020 and 30 June 2021. Patients receiving selpercatinib in 1st line of therapy (LOT) were classified as treatment naïve; others who received it in 2nd or later LOTs were classified as previously treated patients. Baseline characteristics were reported using descriptive analyses; TTD and OS were evaluated using Kaplan-Meier analyses. Results: Table 1 presents baseline characteristics of patients (N=31); 45.2% (n=14) patients were treatment-naïve and 54.8% (n=17) were previously treated who initiated selpercatinib in later LOTs: LOT2 (35.5%; n=11), LOT3 (6.5%; n=2), LOT4 (6.5%; n=2), or LOT5 (6.5%; n=2). Across all LOTs, selpercatinib was initiated as a monotherapy regimen. In previously treated patients, pemetrexed alone (n=2), or in combination with carboplatin and pembrolizumab (n=2) were commonly used prior to selpercatinib initiation. Selpercatinib treatment was ongoing in most patients at the end of follow-up (77.4% [n=24], overall cohort; 85.7% [n=12], treatment-naïve; 70.6% [n=12], previously treated). Most patients were alive at the end of follow-up (83.9% [n=26], overall cohort; 85.7% [n=12], treatment-naive; 82.3% [n=14], previously treated). Medians for TTD and OS analysis were not reached. Conclusions: A greater proportion of selpercatinib-treated patients with a/mNSCLC were men and smokers, contrary to findings from the limited research in this population [1,2]. All patients initiated selpercatinib monotherapy with a majority continuing its use at the end of follow-up. Study findings must be interpreted cautiously due to the small sample size, non-representativeness of the sample, and current lack of data to confirm RET status within the sample.

Table 1

Baseline Demographic, Disease, and Treatment Characteristics in Selpercatinib-treated Patients with a/m NSCLC

Table 1

Corresponding Author: Naleen Raj Bhandari, PhD
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