93P Real-world analysis of first-line maintenance (1LM) immunotherapy (IO) ± pemetrexed for non-squamous (NSQ) advanced/metastatic non-small cell lung cancer (a/mNSCLC) lacking targetable mutations, prior to and during the COVID-19 pandemic

Real-world analyses of 1LM IO ± pemetrexed for patients (pts) with NSQ a/mNSCLC, including the relative impact of 1LM pemetrexed in this setting, are lacking. Here we report a retrospective analysis of 1LM treatment patterns and their outcomes in NSQ a/mNSCLC prior to/during the COVID-19 pandemic in the UK. We obtained retrospective data from the National Disease Registration Service to identify two cohorts of NSQ a/mNSCLC completing ≥4 cycles of first-line (1L) platinum-based chemotherapy+IO+pemetrexed (chemo-IO), diagnosed from 1 March to 31 December 2019 (pre-COVID), or from 1 March to 31 December 2020 (COVID) inclusive. The aims were to summarise baseline characteristics, 1L treatment, overall survival (OS) and time-to-next-treatment or death (TTNTD) in both cohorts, and in a combined cohort of pts receiving 1LM stratified by the presence/absence of 1LM pemetrexed, using Kaplan-Meier methodology. 595 and 516 NSQ a/mNSCLC pts completed ≥4 cycles of chemo-IO in the non-COVID and COVID cohorts, respectively. Median OS and median TTNTD from 1L were numerically shorter for NSQ patients in the COVID vs pre-COVID cohort (Table). In a combined cohort of 1000 pts receiving 1LM, median OS and median TTNTD from 1L were broadly similar with/without pemetrexed in 1LM (Table). Table: 93PEfficacy outcomes from initiation of 1L therapyOverall NSQ cohortsPre-COVID, N=595COVID, N=516Median OS, months (95% CI)19.5 (17.6–22.2)15.7 (14.2–18.0)Median TTNTD, months (95% CI)14.8 (13.5–16.2)12.2 (11.0–13.7)Pre-COVID and COVID combinedNSQ 1LM cohort, N=1000IO + pemetrexed, n=827IO, n=173Median OS, months (95% CI)19.5 (17.5–21.6)18.6 (15.6–23.0)Median TTNTD, months (95% CI)15.0 (13.7–16.2)13.2 (11.7–16.3) Open table in a new tab Among the selected pts with NSQ a/mNSCLC completing ≥4 cycles of chemo-IO, efficacy outcomes were numerically shorter in the COVID vs pre-COVID era. In assessing impact of 1LM pemetrexed: clinical outcomes in a combined cohort of pts receiving 1LM from the non-COVID and COVID era were broadly similar, regardless of 1LM pemetrexed use.