Lung Cancer: Patient Registry Study
1 . INTRODUCTION
2. EXECUTIVE SUMMARY
3 . KEY INSIGHTS
4 . SEGMENTS
Agenda
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The ALCF lung cancer patient registry survey covers most aspects of the lung cancer treatment
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Respondent Profile
1 . INTRODUCTION
2. EXECUTIVE SUMMARY
3 . KEY INSIGHTS
4 . SEGMENTS
Agenda
Executive Summary – Symptoms and Diagnosis
On an average, patients experience ~2 symptoms before diagnosis;
shortness of breath, fatigue and pain are other common symptoms
A significantly higher proportion of non-smokers and younger patients experience symptoms; however, they are treated more for diseases
other than lung cancer initially and thus are often diagnosed at late stages
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• There is a need to educate non-smokers, younger patients and also PCPs about the different symptoms of lung
cancer to help increase the rate of early diagnosis, and consequently, reduce the extent of incorrect treatment
• Patients suspected to have pneumonia should be encouraged for lung cancer screening, given similar symptoms;
screening would reduce the time spent in treating for diseases other than lung cancer
Three-fifths of the patients who visited a PCP were treated for
diseases other than lung cancer leading to delay in diagnosis
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Executive Summary – Testing and Treatment
Biopsy is a well established diagnostic test followed
closely by PET/CT regardless of patient
characteristics
Mutation testing is more common among patients diagnosed at late stages; NGS
is gaining preference though lung cancer specific mutation panel continues to be
significantly preferred – method used does not differ by patient profile
Surgery is most preferred at early stages, while at the
later stages patients are treated with targeted therapy
Targeted therapy is most preferred almost across all mutation
types; immunotherapy is preferred for PDL-1 and KRAS patients
• Mutation testing on patient’s biopsy at an early stage would help make better treatment decisions which are
dependent on the disease stage and mutation type
• Use of next generation sequencing - quick / cost-effective methodology compared to testing for limited number of
genes at a time - could be promoted more
1 . INTRODUCTION
2. EXECUTIVE SUMMARY
3 . KEY INSIGHTS
4 . SEGMENTS
Agenda
Takeaways
Cough (50%), shortness of Breath (32%), fatigue (27%) and pain (25%) are the most common symptoms before being
diagnosed with lung cancer
More than half of the patients visit a Primary Care Physician regarding symptoms
Key Insights – Symptoms
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Key Insights – Testing
Takeaways
Biopsy, PET/CT, and CT are the most commonly performed diagnostic tests
On average, patients undergo about 4 diagnostic tests
Bronchoscopy, fine needle aspiration, and surgery are the most common types of biopsies done
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Takeaways
Three-fourths of the patients have had a molecular / biomarker / genetic testing
Lung cancer specific mutation panel is significantly more likely to be performed compared to Next generation sequencing
Key Insights – Testing
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Among the patients who tested positive for molecular/biomarker/genetic testing, ALK was the most widely identified
mutation type, followed by EGFR and PDL-1
Key Insights – Testing
Takeaways
Takeaways
Almost three-fifths of the patients received initial treatment for something other than lung cancer; the most common disease
these patients received initial treatment for is Pneumonia
Key Insights – Diagnosis
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Takeaways
Among the patients who are currently receiving treatment, almost half are receiving targeted therapy
Targeted therapy is the most preferred choice of treatment across lines, followed by chemotherapy and immunotherapy with
almost equal patient share
Key Insights – Current Treatment
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Takeaways
At the earliest stage of lung cancer- stage I - when the cancer is operable, patients undergo surgery, while at the later
stages - stages 2,3 and 4 - patients are treated with targeted therapy or chemotherapy or immunotherapy
Key Insights – Current Treatment
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Chemotherapy is the most common treatment among patients who’ve received prior treatment, followed by radiation
therapy and surgery
Chemotherapy is a preferred prior treatment option to a significantly higher proportion of patients who are currently in the
2L+ line of therapy, followed by radiation and targeted therapy
Takeaways
Key Insights – Prior Treatment
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1 . INTRODUCTION
2. EXECUTIVE SUMMARY
3 . KEY INSIGHTS
4 . SEGMENTS
Agenda
Segments – Based on Time Taken to Diagnose
Takeaways
Symptoms before the diagnosis of lung cancer and patients receiving initial treatment for diseases other than lung cancer is
more prevalent in patients who were diagnosed later than 3 months
Patients who initially see an ‘Emergency room physician’ or ‘Urgent care’ are significantly likely to be diagnosed in <= 3
months than others
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Segments – Based on Stage of Diagnosis
Takeaways
Patients diagnosed at later stages experienced more symptoms and are more prone to driver mutations
ALK rearrangements are more common in later stages while mutations like EGFR and KRAS were associated with patients
diagnosed at earlier stages
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Segments – Based on Stage of Diagnosis
Takeaways
Brain MRI was used significantly more in patients diagnosed at later stages, as the chances of brain metastases are higher
in these patients
Surgery was the most preferred treatment for patients diagnosed at early stages (since it is operable), while targeted
therapy was used significantly for patients diagnosed at later stages
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Segments – Based on Mutation
Takeaways
Current treatment for PDL1 +ve is focused on immunotherapy options and other mutation types are treated predominantly
with targeted therapies
Segments – Based on Patient’s Smoking History
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Takeaways
Non-smokers considered cough, fatigue, and pain as more serious symptoms than smokers
Lung cancer in non-smokers was diagnosed significantly more at later stages, being first attributed to a respiratory infection
or even allergies or any other disease
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Segments – Based on Patient’s Smoking History
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Takeaways
Lung cancer led brain metastases is more common in non-smokers and hence brain MRI diagnostic test was taken more
significantly among non-smokers
Targeted therapy is more frequently used in non-smokers, primarily driven by stage of diagnosis (85% in later stages) and
mutation type (47% with ALK mutation)
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Segments – Based on Age
Takeaways
A higher proportion of young patients with symptoms were treated for diseases other than lung cancer leading to delayed
diagnosis
Targeted therapy is the preferred treatment option in young patients
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Segments – Time of Survival