Metastatic NSCLC patients in the real world in Finland.

BACKGROUND: Significant progress has been made in the management of metastatic NSCLC (mNSCLC). Our study investigated characteristics, treatment patterns, and outcomes in this patient population and subgroups based on histology and PD-L1 status. METHODS: We conducted a retrospective analysis of electronic health records of patients with mNSCLC 1/2019-8/2023 at HUS, Helsinki University Hospital, Finland. Patient characteristics, treatment, and outcomes were analyzed. RESULTS: We identified 646 patients with mNSCLC, including those metastatic at diagnosis and whose cancer later progressed to metastatic, who received systemic therapy. Median age was 70 years (interquartile range [IQR]: 62-75). Squamous cell carcinoma (SqC) presented 19% of patients, adenocarcinoma 68%, and other non-SqC 13%. Amongst the non-SqC patients 53% were female, whereas only 32% of SqC patients were female. Treatment evolved considerably, with increased use of immuno-oncology (IO) and tyrosine kinase inhibitor (TKI) therapies. Median overall survival was 8 months (confidence interval [CI] 95%: 6-9) for those treated with chemotherapy alone, 12 months (CI 95%: 7-18) for those treated with IO therapy, 14 months (CI 95%: 11-15) for those treated with IO + chemotherapy, and 24 months (CI 95%: 16-38) for those treated with TKIs. INTERPRETATION: Our study reports real-world management of patients with mNSCLC and evolving treatment patterns in clinical practice from the first years of IO treatment availability. As we continue to monitor more recent data, the proportion receiving chemotherapy alone is anticipated to continue decreasing. It is crucial to assess current outcomes in NSCLC to target resources correctly and improve prognosis.