Table 2.
First-Line Treatment Decisions (N = 396) by Patient Presentation for Patients With Metastatic NSCLC
| Patient Presentation | # of Chemotherapy Decisions | # of Clinical Trial Decisions | # of TKI Decisions | # of Immunotherapy +/− Chemotherapya Decisions |
|---|---|---|---|---|
| ALK positiveb | 0 (0) | 0 (0) | 6 (100%) | 0 (0) |
| EGFR sensitizingb | 0 (0) | 2 (3.8) | 51 (96.2%) | 0 (0) |
| ROS1 positive | 0 (0) | 0 (0) | 4 (100%) | 0 (0) |
| PD-L1 1–49% TPSb | 34 (65.4%) | 4 (7.7%) | 9 (17.3%) | 5 (9.6) |
| PD-L1 ≥ 50% TPSb | 3 (4.8%) | 1 (1.6%) | 4 (6.5%) | 54 (87.1) |
| No actionable biomarker | 198 (85.7%) | 15 (6.5%) | 1 (0.4%) | 17 (7.4) |
| Total | 235 (57.6%) | 22 (5.4%) | 75 (18.4%) | 76 (18.6%) |
Abbreviations: ALK, anaplastic lymphoma kinase; EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer; PD-L1, programmed death ligand 1; TPS, tumor proportion score; TKI, tyrosine kinase inhibitor.
One decision was for combination immunotherapy plus chemotherapy (ie, pembrolizumab, pemetrexed, and carboplatin); all others were for single-agent immunotherapy regimens.
Some patients are counted in under multiple patient presentations. Of those with a PD-L1 expression of 1%−49% TPS, 7 were also EGFR sensitizing and 1 was ALK positive. Of those with a PD-L1 expression of ≥ 50% TPS, 3 were also EGFR sensitizing and one was ALK positive. For these patients, providers documented that the patient was to receive a TKI.