Immune Checkpoint Inhibitors for Lung Cancer: Immediate Impact of 2015 ASCO Presentations on Clinical Practice

Introduction

In an effort to provide you with timely market feedback from ASCO 2015, OBR and MDoutlook are pleased to share results from MDoutlook’s OncoPolls™ from the meeting. This first report explored presentations concerning the anti-PD-1 / PD-L1 antibody-based Immune Checkpoint Inhibitors in non-small cell lung cancer (NSCLC).

OncoPoll™ Methodology

  • Primary research phase involved a global survey to verified and validated medical oncologists and multi-disciplinary physicians with an identified clinical interest in lung cancers utilizing targeting parameters within the proprietary MDoutlook® global cancer treater panel
  • Timing: June 2015. Launched 1 week after close of 2015 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago, IL., May 29-June 2, 2015
  • Fielding via interactive web-based survey instrument, utilizing proven MDoutlook methodology and proprietary technology
  • Links to discussed abstracts on the ASCO website were provided within the survey
  • Reponses at data collection: 125

Geographic Distribution of Respondents

Attendance at 2014 ASCO Annual Meeting

Key Conclusions

  • Three-fifths of survey respondents attended this year’s ASCO annual meeting
  • Almost all (97%) who attended ASCO went to at least one Lung cancer session
    • 1/3 attended 6 or more sessions on lung cancer


Survey Participants’ NSCLC Cancer Patient Flow:
Average Nearly 20 Cases Each Month

Key Conclusions

  • Survey participants* averaged 57 cases of NSCLC last 3 months
    • Majority of cases involved metastatic disease
  • Non-mutated, Non-squamous NSCLC was the predominate subtype of NSCLC seen

* Survey Participants = Medical Oncologists with an identified clinical interest in NSCLC


Expected Usage of Immune Checkpoint Blockade Antibodies in Non-Mutated NSCLC

Key Conclusions

  • Physicians expect to use immune checkpoint inhibitors in more than half of 2nd line treatment decisions for non-squamous NSCLC. Even higher usage (~2/3) for squamous NSCLC
    • Only 8% of physicians will not use at all in 2nd line for non-squamous NSCLC; only 2% will never use for squamous histology (data not shown)
  • Strong usage of this approach will persist in later lines as well


Expected Usage of Immune Checkpoint Blockade Antibodies in NSCLC with Driver Mutations

Key Conclusions

  • Primary usage of the immune checkpoint inhibitors in NSCLC with driver mutations will be in the 3rd line or later
    • Approximately 1 line later than in NSCLC without the driver mutations
  • Only 5% of physicians will never use this approach with these NSCLC subtypes

Dual Immune Checkpoint Blockade in NSCLC

Key Conclusions

  • Overall calculated average of 6.35
  • More than 1/3 of respondents (38%) rate the clinical impact of these anti-bodies as high / very high


Perceived Value of Immune Checkpoint Blockade Antibodies in NSCLC

Key Conclusions

  • Overall calculated average of 4.74
  • Over ¼ of physicians (27%) perceive the value of these antibodies, at current prices, as being high / very high

Conclusions: Impact of ASCO 2015 on Immune Checkpoint Inhibitors for Lung Cancer

  • The immune checkpoint inhibitors (anti-PD-1/PD-L1) are going to have a very significant impact on the treatment landscape for NSCLC
  • For cases of NSCLC without driver mutations, treatment with these antibodies is expected to become the primary 2nd line treatment option
    • Nearly 2/3 of squamous NSCLC patients will receive an anti-PD-1/PD-L1 antibodies in the 2nd line
    • About half of non-squamous NSCLC will receive this therapeutic approach in the 2nd line
    • Usage declines in later lines but still remains at respectable levels (20-30% of patients)
  • For cases of NSCLC with driver mutations (ALK+ or mutated EGFR), usage of the anti-PD-1/PD-L1 antibodies will still occur, albeit in 1 later line of therapy (primarily starting in 3rd line)
  • Combining the anti-PD-1/PD-L1 antibodies with the anti-CTLA-4 antibody ipilimumab is seen as a promising approach that will further impact treatment paradigms in the future
  • At today’s prices, physicians see good value in using the anti-PD-1/PD-L1 antibodies for NSCLC
    • 27% of respondents rate their value in NSCLC as high or very high
    • 38% of respondents rate their clinical impact in NSCLC as high or very high

For a more detailed analysis report, please click here to download the full report.

Submitted by Robert Stephan, Sr. Director Medical Services and Strategy, and Jan Heybroek, President MDoutlook.

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