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N. Marschner



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    P3.01 - Advanced NSCLC (ID 621)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P3.01-088 - Molecular Testing and First-Line Treatment of Patients with NSCLC. First Results from the German CRISP Study (AIO-TRK-0315) (ID 9960)

      09:30 - 09:30  |  Author(s): N. Marschner

      • Abstract
      • Slides

      Background:
      Treatment of non-small cell lung cancer (NSCLC) is quickly evolving. New biomarkers and targeted agents have been approved at a rapid pace. It is of high interest to patients, physicians and reimbursement institutions to investigate molecular testing and subsequent treatment decisions in routine practice.

      Method:
      The prospective, national clinical research platform CRISP recruits patients in up to 150 cancer centres in all therapeutic sectors in Germany. Patients will be followed until death or for a maximum of 3 years. Raw data from 717 patients recruited by 78 centers by April 03[rd] was analysed regarding molecular testing and 1[st]-line treatment.

      Result:
      Data on histology was available for 635 patients, 71% non-squamous carcinoma (nsqc), 18% squamous carcinoma (sqc). Median age was 67 years and 61% of patients were male. 11% of patients were never smokers. In patients with nsqc (n=507) molecular test rates for EGFR, ALK, ROS-1 and PD-L1 were 69%, 65%, 51% and 26%, respectively. The overall PD-L1 test rate (nsqc & sqc) was 21% in 2016 and has been 27% so far in 2017. Of patients for whom test results were available at time of analysis 58% (n=87) were PD-L1 positive (nsqc 60%, n=76 and sqc 46%, n=11). An EGFR alteration was detected in 16% (n=57), an ALK alteration in 8% (n=25), and a ROS-1 alteration in 4% (n=9) of nsqc patients. Overall, 53% of patients received a carboplatin-based, 22% a cisplatin-based, and 7% a platin-free chemotherapy, while 14% received targeted and 4% other (experimental) therapies. Patients with EGFR alterations (n=57) were most frequently treated with 1[st]-line afatinib (33%), erlotinib (12%), or gefitinib (11%). Patients with ALK alterations (n=25) were most frequently treated with 1[st]-line crizotinib (48%). Patients with PD-L1 positive tumours were most frequently treated with platinum based doublet therapies (carboplatin combined with gemcitabine/taxane/pemetrexed or cisplatin combined with pemetrexed) or with pembrolizumab. The use of 1[st]-line pembrolizumab increased from 7% to 16% from 2016 to 2017. An update with data collected until October 2017 (>1,100 patients expected) will be presented.

      Conclusion:
      For the first time, CRISP presents real life data from all therapeutic sectors in Germany. Patients are frequently tested for molecular alterations and more than half of the patients with molecular alterations can start 1[st]-line treatment with a targeted therapy. Supported by AstraZeneca, Boehringer Ingelheim, BMS, Celgene, Lilly, MSD, Novartis, Pfizer and Roche.

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