Real-world treatment and overall survival (OS) in patients (pts) with ROS1-positive (ROS1+) non-small cell lung cancer (NSCLC) in England between 2014 and 2023

BackgroundGiven the scarcity of available data on pts with ROS1+ NSCLC, real-world research is needed to provide insights into factors affecting treatment decisions and survival in this pt population. The aim of this retrospective population-based cohort study was to describe treatment pathways and OS in pts with ROS1+ NSCLC in England using data from the national Cancer Analysis System (CAS).MethodsIncluded pts were adults with a stage I–IV NSCLC diagnosis between Jan 2014 and Dec 2020 (follow-up to Jan 2023) and a ROS1 alteration test during the study. Per CAS rules, no OS data are available from pts receiving drugs categorised under the English Cancer Drugs Fund (CDF) during the study, and data are currently masked by rounding to the nearest 10 pts; unmasked data will be presented.ResultsOf 12,450 included pts, 150 (1.2%) had NSCLC with a ROS1 alteration. Of these 150 pts, 60 received crizotinib under the CDF (median age, 63 yrs; 20 were male; 60 had non-squamous [NSQ] histology; and 50 had stage IV disease) and 90 did not receive drugs under the CDF (median age, 69 yrs; 40 were male; 80 had NSQ histology; and 40 had stage IV disease). Forty of these 90 pts had stage I–III NSCLC and received initial treatment of curative intent, most commonly surgery alone or with adjuvant systemic anticancer therapy (SACT) and/or radiotherapy (RT). The remaining 50 pts (all stages) received SACT and/or palliative RT or best supportive care (BSC). Median (Q1–Q3) OS from diagnosis was 41.0 (27.3–not reached [NR]) mo in the 40 pts receiving treatment of curative intent, with a 24-mo OS rate of 86%, and 24.1 (4.8–NR) mo in the 50 pts receiving SACT and/or palliative RT or BSC, with a 24-mo OS rate of 50%. In a subgroup of 30 pts with ROS1+ stage III–IV NSCLC receiving treatments not under the CDF, median (Q1–Q3) OS from first treatment was 28.5 (10.5–NR) mo, with a 24-mo OS rate of 70%. Final analyses will include pts with stage I–III NSCLC progressing to advanced disease and treatments.ConclusionsThis population-based cohort study provides insights into treatment and OS for pts with ROS1+ NSCLC in England, highlighting the unmet need for alternative therapies.Editorial acknowledgementProfessional medical writing and editorial assistance were provided by Richard Daniel, PhD, of Parexel, funded by Bristol Myers Squibb.Legal entity responsible for the studyBristol Myers Squibb.FundingBristol Myers Squibb.DisclosureA. Greystoke: Financial Interests, Personal, Advisory Board: BMS, AstraZeneca, Boehringer Ingelheim, Takeda, Roche, Novartis; Financial Interests, Personal, Invited Speaker: Merck, MSD, Pfizer, Janssen; Financial Interests, Institutional, Local PI: MSD; Financial Interests, Institutional, Coordinating PI: Pfizer, AstraZeneca, Novartis, Achilles; Non-Financial Interests, Advisory Role: National Institue for Health and Clinical Excellence; Non-Financial Interests, Leadership Role, Steering Committee member: British Thoracic Oncology Group; Other, Clinical Lead for Cancer (paid position): North East Englad and Yorkshire Genomic Laboratory Hub. G. Emanuel: Financial Interests, Institutional, Full or part-time Employment, I am an employee of Bristol Myers Squibb: Bristol Myers Squibb. C. Rault: Financial Interests, Institutional, Other, Leading epidemiological aspect on IO Optimise, consultancy: Bristol Myers Squib. J. Penrod: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb. C. Calvet: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb; Financial Interests, Personal, Stocks/Shares: Bristol Myers Squibb. Y. Yuan: Financial Interests, Personal, Full or part-time Employment, an employee of BMS: Bristol Myers Squibb; Financial Interests, Personal, Stocks/Shares, an employee of BMS: Bristol Myers Squibb. S. Lay-Flurrie, E. Markov, E. Asenova, V. Saglimbene: Financial Interests, Personal, Full or part-time Employment: IQVIA. A. Lee: Financial Interests, Personal, Full or part-time Employment, employee of BMS: Bristol Myers Squibb (BMS); Financial Interests, Personal, Stocks/Shares, employee of BMS: Bristol Myers Squibb (BMS). All other authors have declared no conflicts of interest.