Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Comparative Analysis of Biomarker Testing Rates and Treatment Patterns in NSCLC Patients: Australia vs. EU4+UK (#334)

Imogen Smith 1 , Clara Brown 1 , James Etwell 1 , Lawrence Farrell 1 , Emma Peffer 1 , Euan Wilson 1 , Stephen Della-Fiorentina 2 3
  1. IQVIA, Australia, NSW
  2. School of Medicine, Western Sydney University , Campbelltown, NSW, Australia
  3. Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia

Aim:

Non-small cell lung cancer (NSCLC) has a poor five-year survival rate, highlighting the need for optimised treatment via molecular testing of predictive biomarkers. This study compares biomarker test rates and results between Australian and EU4+UK patients to address NSCLC disparities.

Methods:

We analysed anonymised patient-level data from the cross-sectional online survey conducted by the IQVIA Oncology Dynamics real-world data database. The Australian cohort (n=515) covered 2022-2024, while the EU4+UK cohort (n=10448) included the most recent moving annual total (MAT) to March 2024. We focused BRAF, EGFR, ROS1, ALK and PD-1/PD-L1 testing rates, results, and treatment patterns.

Results:

Australia had higher ALK testing rates (88%) than the EU4+UK (82%), with ALK positivity at 5% and 10%, respectively. Most ALK-positive patients received ALK inhibitors (100% vs 95%). BRAF testing rates were 63% in Australia and 59% in the EU4+UK, with a 1% positivity. In Australia, 86% of BRAF-positive patients received PD-1/PD-L1 inhibitors, while 46% in the EU4+UK received BRAF inhibitors. ROS1 testing rates were higher in Australia (84% vs 71%), with ROS1 positivity at 2% and 1%, respectively. Most ROS1-positive patients received ROS1 inhibitors (60% vs 64% respectively). EGFR testing rates were similar in Australia (88%) and the EU4+UK (84%), with an equal 21% positivity rate. Most EGFR-positive patients received EGFR inhibitors (79% vs 84%). PD-1/PD-L1 testing rates were higher in Australia (91%) compared to the EU4+UK (85%), with positivity rates of 73% and 64%, respectively. Most PD-1/PD-L1-positive patients received PD-1/PD-L1 inhibitors (64% in Australia and 58% in the EU4+UK).

Conclusions: Australia’s stricter adherence to testing protocols led to higher mutation rates. Variations in treatment choices, particularly limited use of BRAF inhibitors in Australia, highlight regional differences and access to subsidised therapies. Standardised testing protocols and equitable access to treatments could enhance global NSCLC care, reducing disparities and improving patient outcomes.