LUMINATE-101-Maccabi: a real-world study of treatment patterns and clinical outcomes in patients with non-squamous metastatic non-small cell lung cancer in an Israeli Health Maintenance Organization (HMO).

BACKGROUND: Treatment options for non-small cell lung cancer (NSCLC) patients lacking actionable genetic alterations (non-AGA) remain limited, particularly after first-line (1L) therapy. This study evaluated real-world treatment patterns and outcomes among second or later-line (2L+) patients with non-AGA non-squamous (NSQ) metastatic NSCLC (mNSCLC) at a Health Maintenance Organization in Israel.

METHODS: A retrospective cohort study used de-identified data from the Maccabi Healthcare Services database to identify 2L+ adult patients with non-AGA NSQ mNSCLC between January 2017 and December 2020. Outcomes included progression-free survival (PFS), overall survival (OS), and time-to-next-treatment or death (TTNTD), analyzed using descriptive statistics and Kaplan-Meier methodology.

RESULTS: Among 176 2L+ patients, median age was 67 years, 66.5% were male, 51.7% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and 30.7% received third-line therapy. Anti-programmed death-receptor/ligand 1 (anti-PD-[L]1) was the most common 2L therapy (n = 74, 42.0%) following 1L chemotherapy. Median overall TTNTD from 2L initiation was 3.73 months (docetaxel: 1.78 months; anti-PD-[L]1 combination: 7.05 months). Median overall PFS was 2.56 months (docetaxel: 1.78 months; anti-PD-[L]1 combination: 9.48 months) and median overall OS was 5.51 months (docetaxel: 1.81 months; anti-PD-[L]1 combination: 9.48 months).

CONCLUSIONS: These findings highlight the high unmet need among 2L+ non-AGA NSQ mNSCLC patients in Israel.