Real-world evidence is suggesting, for the first time, the most beneficial treatment courses that could help extend the lives of patients with metastatic non-small cell lung cancer, according to research from the Abramson Cancer Center at the University of Pennsylvania.
In a new study published online in JAMA Oncology, researchers show that patients harboring a KRAS gene mutation with high levels of PDL-1 lived longer when treated with immunotherapy alone, compared to patients without this mutation. This survival difference by KRAS status was not seen, however, in patients treated with both chemotherapy and immunotherapy, suggesting combination therapy for patients without the mutation may be preferred.
The new findings, based off an analysis of the Flatiron Health database that includes aggregated, de-identified data from the electronic health records of more than 65,000 patients with advanced non-small-cell lung cancer, provide much-needed guidance to treat a disease that has a five-year survival of just 35 per cent.
“This is a prime example of how real-world data can complement clinical trial data to help inform decision making between patients and their oncologists,” said senior author Ronac Mamtani, MD, an assistant professor of Hematology-Oncology in the Perelman School of Medicine at the University of Pennsylvania.
These findings are applicable to a large subset of lung cancer patients, the researchers said.
“A third of patients with non-small cell lung cancer have high PD-L1, and of those patients, many have a mutation in KRAS,” said co-senior author Charu Aggarwal, MD, MPH, the Leslye M. Heisler Associate Professor for Lung Cancer Excellence in Penn’s Perelman School of Medicine. “There will be clinical implications for a large portion of patients with advanced lung cancer, as we learn more about this mutation and how other mutations may play a role in response.”
Source: University of Pennsylvania