Non-squamous, Non-Small Cell Lung Cancer
Conditions
Brief summary
Characteristics of patients with Neuregulin-1 (NRG1) gene fusion-positive solid tumors treated with afatinib, and characteristics of those treated with another systemic therapy.
Interventions
Afatinib
other systemic therapy
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults, 18 years of age or older, at the time of diagnosis with any solid tumor. * Confirmed NRG1 gene fusion in any solid tumor. * Initiated afatinib or other systemic therapy (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01/01/2017 through 03/31/2020. * Followed up for ≥3 months after initiation of afatinib or other systemic therapy (unless deceased prior to 3 months of follow-up).
Exclusion criteria
\- Treatment with any Tyrosine kinase inhibitor (TKI)/ErbB-directed therapy other than afatinib
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response (response based on the scan where the patient showed the best response to treatment (not progression)). Charted/physician-reported (physician-provided information as recorded in patient's chart) ORR is reported. |
| Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | ORR based on lesion measurements and RECIST v1.1 criteria is reported. ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): CR: Disappearance of all target lesions or disappearance of all non-target lesions. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. |
| Duration of Objective Response (DOR) | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | DOR was defined as the time from initial response (for any patient with a complete or partial response initially) until the earliest of either disease progression or death. Duration of response is reported for those patients who had a complete or partial response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date. |
| Duration of Clinical Benefit (DOCB) | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | DOCB was defined as the time from initial response (for any patient with a complete, partial, or stable disease response initially) until the earliest of either disease progression or death. DOCB reported for those patients who had a complete, partial or response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date. |
| Progression Free Survival (PFS) | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | PFS was defined as time from initiation of a line of therapy until disease progression or death; patients on therapy at the time of data cut-off were censored on the last date of treatment. Patients who discontinued a line of therapy for a reason other than disease progression but who subsequently die prior to the receipt of any other therapy were considered an event on the date of death. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): Progressive disease (PD): at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study), or unequivocal progression of existing non-target lesions, or the appearance of one or more new lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of at least 5 millimeter (mm). |
| Time on Treatment (TOT) | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | TOT was defined as time from initiation of a line of therapy until discontinuation for any reason. Patients on therapy at the time of data cut-off were censored on the last date of treatment. |
| Time to Progression (TTP) | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | TTP was defined as time from initiation of a line of therapy until discontinuation due to disease progression. Patients on therapy or those who discontinued due to a reason other than disease progression were censored on the last date of treatment. |
| Overall Survival (OS) | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | OS was defined as time from initiation of any therapy in the metastatic setting until death. Patients alive at the time of data cut-off were censored on the last date the patient was seen by the provider/clinic. |
| Number of Patients Who Experienced Any ADRs During Index Treatment Line | From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days. | Number of patients who experienced any averse drug reactions (ADRs) during index treatment line is reported. An ADR was defined as a response to a medicinal product which is noxious and unintended. Response in this context means that a causal relationship between a medicinal product and an adverse event (AE) is at least a reasonable possibility. |
Countries
United States
Participant flow
Recruitment details
This was a non-interventional, retrospective, United States (US), multi-site, cohort study based on existing data from medical records of patients with Neuregulin-1 (NRG1) gene fusion-positive solid tumors treated with afatinib or other systemic therapy.
Pre-assignment details
Only subjects that met all inclusion and none of the exclusion criteria were included.
Participants by arm
| Arm | Count |
|---|---|
| All Afatinib Patients Patients with a confirmed Neuregulin-1 (NRG1) gene fusion in any solid tumor, who initiated treatment with afatinib (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01-January-2017 through 31-March-2020 and followed up for ≥3 months after initiation of afatinib (unless deceased prior to 3 months of follow-up). | 72 |
| All Non-afatinib (Other Systemic Therapies) Patients with a confirmed Neuregulin-1 (NRG1) gene fusion in any solid tumor, who initiated treatment with other systemic therapies than afatinib (in any line of therapy) for treatment of a solid tumor with NRG1 gene fusion on or after 01-January-2017 through 31-March-2020 and followed up for ≥3 months after initiation of other systemic therapies than afatinib (unless deceased prior to 3 months of follow-up). | 38 |
| Total | 110 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 1 | 3 |
| Overall Study | Disease progression (confirmed with scan) | 57 | 11 |
| Overall Study | Scheduled duration of therapy complete | 1 | 9 |
| Overall Study | Toxicity/intolerability | 3 | 1 |
Baseline characteristics
| Characteristic | All Non-afatinib (Other Systemic Therapies) | All Afatinib Patients | Total |
|---|---|---|---|
| Age, Continuous | 66 Years | 62 Years | 62.5 Years |
| Comorbidities Cardiovascular disease | 14 Participants | 0 Participants | 14 Participants |
| Comorbidities Chronic pulmonary disease | 12 Participants | 16 Participants | 28 Participants |
| Comorbidities Depression | 0 Participants | 17 Participants | 17 Participants |
| Comorbidities Diabetes with chronic complications | 12 Participants | 0 Participants | 12 Participants |
| Comorbidities Hypertension | 21 Participants | 29 Participants | 50 Participants |
| Comorbidities None of the above | 10 Participants | 15 Participants | 25 Participants |
| Eastern Cooperative Oncology Group Performance Status (ECOG-PS) 0,1 | 26 Participants | 22 Participants | 48 Participants |
| Eastern Cooperative Oncology Group Performance Status (ECOG-PS) 2+ | 12 Participants | 50 Participants | 62 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 5 Participants | 10 Participants | 15 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 33 Participants | 62 Participants | 95 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Geographic Region Midwest | 4 Participants | 5 Participants | 9 Participants |
| Geographic Region Northeast | 10 Participants | 26 Participants | 36 Participants |
| Geographic Region South | 24 Participants | 15 Participants | 39 Participants |
| Geographic Region West | 0 Participants | 26 Participants | 26 Participants |
| Line of therapy in which index therapy was received First line therapy (1L) | 36 Participants | 16 Participants | 52 Participants |
| Line of therapy in which index therapy was received Second line therapy (2L) | 2 Participants | 51 Participants | 53 Participants |
| Line of therapy in which index therapy was received ≥ third line therapy (3L+) | 0 Participants | 5 Participants | 5 Participants |
| NRG1 testing characteristics: NRG1 testing location Caris Life Sciences | 0 Participants | 15 Participants | 15 Participants |
| NRG1 testing characteristics: NRG1 testing location Foundation One | 27 Participants | 29 Participants | 56 Participants |
| NRG1 testing characteristics: NRG1 testing location Other | 1 Participants | 3 Participants | 4 Participants |
| NRG1 testing characteristics: NRG1 testing location Specialty gene testing lab | 7 Participants | 11 Participants | 18 Participants |
| NRG1 testing characteristics: NRG1 testing location Tempus | 0 Participants | 3 Participants | 3 Participants |
| NRG1 testing characteristics: NRG1 testing location Unknown | 3 Participants | 11 Participants | 14 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 6 Participants | 6 Participants |
| Race (NIH/OMB) Black or African American | 16 Participants | 16 Participants | 32 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 22 Participants | 48 Participants | 70 Participants |
| Sex: Female, Male Female | 18 Participants | 30 Participants | 48 Participants |
| Sex: Female, Male Male | 20 Participants | 42 Participants | 62 Participants |
| Smoking status at initiation of index therapy Current smoker | 2 Participants | 2 Participants | 4 Participants |
| Smoking status at initiation of index therapy Never smoked | 14 Participants | 32 Participants | 46 Participants |
| Smoking status at initiation of index therapy Past history of smoking | 22 Participants | 38 Participants | 60 Participants |
| Tumor stage at initiation of index therapy Stage I | 0 Participants | 0 Participants | 0 Participants |
| Tumor stage at initiation of index therapy Stage II | 3 Participants | 1 Participants | 4 Participants |
| Tumor stage at initiation of index therapy Stage III | 1 Participants | 6 Participants | 7 Participants |
| Tumor stage at initiation of index therapy Stage IV | 34 Participants | 65 Participants | 99 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 72 | 3 / 38 |
| other Total, other adverse events | 2 / 72 | 3 / 38 |
| serious Total, serious adverse events | 0 / 72 | 4 / 38 |
Outcome results
Duration of Clinical Benefit (DOCB)
DOCB was defined as the time from initial response (for any patient with a complete, partial, or stable disease response initially) until the earliest of either disease progression or death. DOCB reported for those patients who had a complete, partial or response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020 and had a complete, partial, or stable disease response according to charted/physician-reported disease response.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Afatinib Patients | Duration of Clinical Benefit (DOCB) | 5.85 months |
| All Non-afatinib (Other Systemic Therapies) | Duration of Clinical Benefit (DOCB) | 13.38 months |
| First Line Afatinib Patients | Duration of Clinical Benefit (DOCB) | NA months |
| First Line Non-afatinib Patients | Duration of Clinical Benefit (DOCB) | 13.38 months |
Duration of Objective Response (DOR)
DOR was defined as the time from initial response (for any patient with a complete or partial response initially) until the earliest of either disease progression or death. Duration of response is reported for those patients who had a complete or partial response according to charted/physician-reported disease response. Patients who discontinued therapy due to a reason other than progression were censored on the date of discontinuation. Patients still on therapy at the time of data cut-off were censored on their last visit date.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020 and had a complete or partial response according to charted/physician-reported disease response.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Afatinib Patients | Duration of Objective Response (DOR) | 5.851 months |
| All Non-afatinib (Other Systemic Therapies) | Duration of Objective Response (DOR) | 13.38 months |
| First Line Afatinib Patients | Duration of Objective Response (DOR) | NA months |
| First Line Non-afatinib Patients | Duration of Objective Response (DOR) | 13.38 months |
Number of Patients Who Experienced Any ADRs During Index Treatment Line
Number of patients who experienced any averse drug reactions (ADRs) during index treatment line is reported. An ADR was defined as a response to a medicinal product which is noxious and unintended. Response in this context means that a causal relationship between a medicinal product and an adverse event (AE) is at least a reasonable possibility.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| All Afatinib Patients | Number of Patients Who Experienced Any ADRs During Index Treatment Line | 7 Participants |
| All Non-afatinib (Other Systemic Therapies) | Number of Patients Who Experienced Any ADRs During Index Treatment Line | 8 Participants |
| First Line Afatinib Patients | Number of Patients Who Experienced Any ADRs During Index Treatment Line | 2 Participants |
| First Line Non-afatinib Patients | Number of Patients Who Experienced Any ADRs During Index Treatment Line | 8 Participants |
Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response
ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response (response based on the scan where the patient showed the best response to treatment (not progression)). Charted/physician-reported (physician-provided information as recorded in patient's chart) ORR is reported.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Afatinib Patients | Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response | 37.5 percentage of patients |
| All Non-afatinib (Other Systemic Therapies) | Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response | 76.3 percentage of patients |
| First Line Afatinib Patients | Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response | 43.8 percentage of patients |
| First Line Non-afatinib Patients | Objective Response Rate (ORR): Based on Charted/Physician-reported Disease Response | 77.8 percentage of patients |
Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria
ORR based on lesion measurements and RECIST v1.1 criteria is reported. ORR was defined as the percentage of patients with a complete response (CR) or partial response (PR) out of all patients (CR+PR/all patients) at initial response assessment and best response. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): CR: Disappearance of all target lesions or disappearance of all non-target lesions. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Afatinib Patients | Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria | 34.7 percentage of patients |
| All Non-afatinib (Other Systemic Therapies) | Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria | 71.1 percentage of patients |
| First Line Afatinib Patients | Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria | 43.8 percentage of patients |
| First Line Non-afatinib Patients | Objective Response Rate (ORR): Based on Lesion Measurements and RECIST v1.1 Criteria | 72.2 percentage of patients |
Overall Survival (OS)
OS was defined as time from initiation of any therapy in the metastatic setting until death. Patients alive at the time of data cut-off were censored on the last date the patient was seen by the provider/clinic.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Afatinib Patients | Overall Survival (OS) | 7.166 months |
| All Non-afatinib (Other Systemic Therapies) | Overall Survival (OS) | 22.551 months |
| First Line Afatinib Patients | Overall Survival (OS) | 9.928 months |
| First Line Non-afatinib Patients | Overall Survival (OS) | 22.55 months |
Progression Free Survival (PFS)
PFS was defined as time from initiation of a line of therapy until disease progression or death; patients on therapy at the time of data cut-off were censored on the last date of treatment. Patients who discontinued a line of therapy for a reason other than disease progression but who subsequently die prior to the receipt of any other therapy were considered an event on the date of death. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1): Progressive disease (PD): at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study), or unequivocal progression of existing non-target lesions, or the appearance of one or more new lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of at least 5 millimeter (mm).
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Afatinib Patients | Progression Free Survival (PFS) | 5.490 months |
| All Non-afatinib (Other Systemic Therapies) | Progression Free Survival (PFS) | 12.886 months |
| First Line Afatinib Patients | Progression Free Survival (PFS) | 6.345 months |
| First Line Non-afatinib Patients | Progression Free Survival (PFS) | 12.89 months |
Time on Treatment (TOT)
TOT was defined as time from initiation of a line of therapy until discontinuation for any reason. Patients on therapy at the time of data cut-off were censored on the last date of treatment.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Afatinib Patients | Time on Treatment (TOT) | 5.42 months |
| All Non-afatinib (Other Systemic Therapies) | Time on Treatment (TOT) | 5.08 months |
| First Line Afatinib Patients | Time on Treatment (TOT) | 6.34 months |
| First Line Non-afatinib Patients | Time on Treatment (TOT) | 5.08 months |
Time to Progression (TTP)
TTP was defined as time from initiation of a line of therapy until discontinuation due to disease progression. Patients on therapy or those who discontinued due to a reason other than disease progression were censored on the last date of treatment.
Time frame: From the index date (i.e., anytime between 01-January-2017 and 31-March-2020) until data collection (i.e. 11-Nov-2020 to 20-Jan-2021), up to 4 years and 19 days.
Population: All patients who initiated index therapy (i.e., afatinib in any line; other systemic therapy among those without any history of afatinib) between 01 January 2017 and 31 March 2020.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Afatinib Patients | Time to Progression (TTP) | 5.49 months |
| All Non-afatinib (Other Systemic Therapies) | Time to Progression (TTP) | 12.89 months |
| First Line Afatinib Patients | Time to Progression (TTP) | 6.44 months |
| First Line Non-afatinib Patients | Time to Progression (TTP) | 12.89 months |