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Real-World Treatment Patterns and Effectiveness of Targeted and Immune Checkpoint Inhibitor Based Systemic Therapy in BRAF-Mutation Positive Non-Small Cell Lung Cancer

Open AccessPublished:January 09, 2023DOI:https://doi.org/10.1016/j.jtocrr.2022.100460
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      Abstract

      Introduction

      BRAF mutations (present in 2-3% of non-small cell lung cancer) are a known oncogenic driver and emerging therapeutic target. There is a scarcity of real-world data describing the clinical characteristics, treatment patterns and effectiveness of targeted BRAF-inhibiting and immune checkpoint inhibitor (ICI)-based systemic therapies, yet this is required for appropriate treatment decisions which optimize patient outcome.

      Methods

      Demographic, clinical, treatment and outcome data of BRAF-mutation positive diagnosed between 2018 and 2022 were identified from the Glans-Look Lung Cancer Research database and included in this analysis.

      Results

      53 BRAF-mutations positive patients were identified (V600E, n=35; Non-V600E, n=18). 46 patients (87%) were diagnosed with metastatic disease, of which 61% were treated with systemic anti-cancer therapy, which significantly improved overall survival (34.1 vs. 2.2 months, p=0.01). ICI-based regimens showed effectiveness in the first-line setting for both V600E and Non-V600E cohorts (Objective response rate (ORR): 38-43%; median progression free survival (RW-mPFS): 10.5-10.8 months, respectively). Targeted dual BRAF/MEK-inhibition also showed effectiveness in the first-line setting for V600E patients (ORR: 33%, RW-mPFS: 15.2 months).

      Conclusion

      This study of real-world patients with BRAF-mutations confirms the importance of effective systemic therapies. Both dual targeted BRAF/MEK-inhibition and ICI-based regimens show evidence of benefit in this population and demonstrate that real-world populations can experience similar clinical response and outcome to clinical trial cohorts on these treatment regimens. Future studies to clarify the role co-mutations on response to both dual targeted BRAF/MEK-inhibition and ICI-based regimens may be important to treatment selection and optimization of patient outcome.

      Keywords