90P Real-world (RW) post-progression outcomes and treatment (tx) patterns after first-line (1L) immuno-oncology (IO) regimens in patients (pts) with metastatic (m) NSCLC: CORRELATE

Understanding RW outcomes of pts treated with 1L IO ± chemotherapy (CT) may help identify unmet needs and inform future tx strategies. One aim of CORRELATE was to describe post-progression outcomes and second- (2L)/third-line (3L) tx patterns after 1L IO tx in pts with mNSCLC. Using the US Flatiron Clinico-Genomic Database, we analysed outcomes and 2L/3L tx patterns in pts with mNSCLC who started US-approved 1L IO tx between 1 Nov 2016 and 31 May 2021, and met select eligibility criteria from 4 pivotal RCTs (KEYNOTE KN-024, n=94; KN-189, n=462; KN-407, n=122; IMpower150, n=4; N=682). Time to first subsequent tx (TFST; time from start of 1L tx to start of 2L tx or death) and time to next tx (TTNT; time from start of 2L tx to start of 3L tx or death) in all pts, and within subgroups (IO monotherapy mono vs IO + CT, and early vs later progressors) were estimated by Kaplan-Meier analysis. 94 (13.8%) pts received IO mono and 588 (86.2%) IO + CT. 275 (40.3%) received 2L tx; 257 (37.7%) died with no 2L tx; 50 (7.3%) were alive with progressive disease (PD) but no 2L tx; and 100 (14.7%) were alive without PD at data cutoff (31 Dec 2021). 106 (15.5%) received 3L tx. 334 (49.0%) pts had PD or died ≤6 months (mo) after starting 1L IO (early progressors). Median TFST was 7.7 mo and median TTNT was 4.7 mo (Table). Median TFST and TTNT were longer in pts who received 1L IO mono vs IO + CT. Across all subgroups, median TFST was longer than median TTNT. 19.6% (54/275) of pts received IO at 2L and 20.8% (22/106) at 3L; 16.0% (17/106) of pts were rechallenged with IO in 3L after not having IO in 2L. CT ± anti-VEGF was the most common 2L (59.6% 164/275) and 3L (63.2% 67/106) regimen.Table: 90PAll1L IO mono1L IO + CTEarly progressors*Later progressors†2L tx, %n=275n=41n=234n=123n=152CT34.541.533.335.833.6CT + anti-VEGF25.19.827.833.318.4IO ± CT/other19.622.019.213.025.0Targeted tx9.117.17.77.310.5Other11.69.812.010.612.5TFST (1L–2L), moMedian 95% CI7.7 6.8–8.49.5 5.6–13.17.5 6.8–8.35.4 4.9–5.910.5 9.1–11.93L tx, %n=106n=18n=88n=49n=57CT45.350.044.349.042.1CT + anti-VEGF17.911.119.322.414.0IO ± CT/other20.827.819.310.229.8Targeted tx3.804.54.13.5Other12.311.112.514.310.5TTNT (2L–3L), moMedian 95% CI4.7 3.9–5.86.5 4.6–8.03.9 3.3–5.34.9 2.8–6.04.6 3.4–6.1*PD or died ≤6 mo after starting 1L IO; †PD or died >6 mo after starting 1L IO Open table in a new tab *PD or died ≤6 mo after starting 1L IO; †PD or died >6 mo after starting 1L IO Nearly half of the population treated with 1L IO progressed or died within 6 mo from the start of tx, highlighting that improved tx options for pts with mNSCLC remain an important unmet need. For pts able to receive 2L tx, options are limited and results remain suboptimal.