# Real-World Treatment Patterns and Survival in Patients with ROS1-Positive Advanced Non-Small Cell Lung Cancer in Canada and Europe

## TL;DR

This study examines real-world treatment patterns and survival outcomes for patients with ROS1-positive advanced non-small cell lung cancer in Canada and Europe, finding that targeted therapies may offer better survival than non-targeted treatments.

## Contribution

The study provides real-world evidence on treatment patterns and survival outcomes for ROS1-positive advanced NSCLC patients across multiple European countries and Canada.

## Key findings

- ROS1-targeted therapies showed a tendency for longer survival compared to non-targeted treatments like chemotherapy.
- Median overall survival for patients on ROS1-targeted therapy was 47.9 months, versus 29.3 months for non-targeted therapy.
- Most patients had a de novo diagnosis of advanced NSCLC, with limited survival outcomes highlighting the need for better treatments.

## Abstract

There is currently an insufficient amount of real-world information on treatments and outcomes among people with advanced-stage non-small cell lung cancer (NSCLC) who have mutations in the ROS1 gene, termed ROS1-positive advanced NSCLC. We used pooled data collected between 2009 and 2024 from clinical sites in Canada, France, Germany, Portugal, and Spain to assess patients with ROS1-positive advanced NSCLC with the aim of describing patient characteristics, treatment patterns, and survival. In this study, results from 103 patients with ROS1-positive advanced NSCLC who received systemic anticancer therapy indicated a tendency for longer survival using currently available treatment that specifically targets ROS1-positive disease than with non-targeted treatments, such as chemotherapy. However, the observed survival outcomes were less than optimal, highlighting the importance of more effective emerging treatments for patients with ROS1-positive advanced NSCLC.

Real-world data on patients with ROS1-positive advanced non-small cell lung cancer (NSCLC) remain scarce. In this descriptive observational retrospective cohort study, we describe characteristics, treatments, and real-world progression-free survival (rwPFS) and overall survival (OS) among patients with ROS1-positive advanced NSCLC (de novo or recurrent) using secondary data pooled from clinical sites in Canada, France, Germany, Portugal, and Spain as part of the Oncology Evidence Network. Site-specific patient inclusion periods occurred between 2009 and 2023, with follow-up to 2024, allowing ≥1 year of potential follow-up at each site. In total, 108 patients were included, with most (n = 105; 97.2%) having a de novo diagnosis of advanced NSCLC. 103 patients (95.4%) received ≥1 line of systemic anticancer therapy (SACT), of which 65 (63.1%) received first-line targeted therapy, mostly crizotinib monotherapy (n = 45) or crizotinib-based regimens (n = 10), with a median (95% CI) rwPFS and OS of 14.0 (8.3–19.8) and 47.9 (27.3–not estimable) months, respectively. Thirty-eight of the 103 SACT-treated patients (36.9%) received first-line non-targeted therapy, mostly platinum-based chemotherapy (n = 26); median (95% CI) rwPFS and OS were 9.0 (7.5–11.0) and 29.3 (17.7–65.7) months, respectively. Results from this study indicated a tendency for longer survival using currently available ROS1-targeted versus non-targeted therapy for patients with ROS1-positive advanced NSCLC. Nevertheless, survival outcomes were limited, highlighting the importance of more effective emerging treatments for ROS1-positive disease.