General and age-dependent development of firstline (1L) therapies in patients with metastatic non-small cell lung cancer (NSCLC) from 2016 – 2024 in the standard care situation of oncological practices

Background: Oncological therapies are often decided individually on the basis of biological factors like age or general condition pas the most important factors. Age can influence the choice of therapy, especially in NSCLC, since there are broad options of different therapies available. Because of availability of new therapies in the past years we evaluated the development of the 1L therapies in patients with metastatic NSCLC from 2016-2024 ans specific in the age groups 75 years and >75 years.

Methods: Longitudinal data of patients with metastatic NSCLC and start of 1L therapy in 2016 – 2024 were captured by n=25 oncological practices across Germany. The data were examined for general and age-dependent therapy behavior (all pat., 75y and >75y) in 2016-2019, 2020-2021 and 2022-2024.

Results: Overall, n = 1250 patients were treated in 1L with a total of 83 different therapy regimens. The median age at start 1L was 68,0 years and the distribution to groups ≤75y/>75y was 76,8%/23,2%,, to male/female 55,6%/44,4%, and to PECA/N-PECA 24,9%/75,1%. In the age group 75y Cisplatin/Carboplatin was used as combination to ICI in 30,4%/69,6%, whereas the proportion in group  >75y was 17,4%/82,6%.

Conclusions: Over the past 8 years we found for all patients constant rates for ICI mono, but an extensive shift from combination chemotherapy to ICI combination therapies. The proportion of all ICI containing therapies enhanced from 33,1% in 2016-2019 to 79,9% in 2022-2024 and in parallel the proportion of chemotherapy +/- Bevacizumab decreased from 58,4% to 13,6%. In 2022-2024 patients >75y were compared to ≤75y more often treated with ICI mono (30,3%/19,9%) and less with ICI combinations (44,7%/59,6%).  

Dr. Rainer Lipp is German board certified hematologist/medical oncologist and specialized in standard care research of hematological and oncological diseases in Germany. Dr. Lipp has worked at Lung Clinic Großhansdorf, University Hospital Münster and University Hospital Hamburg-Eppendorf before he co-founded the research and consulting company GermanOncology. As medical lead he built up a network of oncologist in more than 20 own practices across Germany and collected more than 15,000 longitudinal datasets about treatments of patients with 25 different oncological and hematological diseases. Additionally, he is currently head of project management for non-interventional studies on behalf of pharmaceutical companies and of business consulting for building of new outpatient settings at hospitals and for reimbursement processes.