New Survey of U.S. Oncologists Reveals Where More Work Can Be Done to Research Treatments for Advanced Non-Small Cell Lung Cancer

Survey examined oncologists’ perspective on treatment options and priorities, comorbidities and other clinical characteristics of patients with advanced NSCLC

Newswise — New York, N.Y., January 24, 2024 – Results from a new survey of U.S. medical oncologists on the current state of advanced non-small cell lung cancer (NSCLC) indicate that more research is needed in several areas to help improve potential outcomes for patients. The survey, conducted online by The Harris Poll, was commissioned by the Cancer Research Institute (CRI) and Regeneron Pharmaceuticals, and included 250 oncologists who treat patients with advanced NSCLC and found a majority agree on the importance of having multiple treatment options for patients (96%) and that they would be interested in additional research focused on new combination treatments involving immunotherapy (71%).

“I have seen firsthand the significant impact that an advanced NSCLC diagnosis has on patients, their families and health systems,” said Julie Brahmer, M.D., M.Sc., Co-Director of the Upper Aerodigestive Department, Bloomberg Kimmel Institute for Cancer Immunotherapy at Johns Hopkins. “These findings remind us there is still work to do and that our collective dedication to the research of advanced NSCLC, specifically in areas such as biomarker testing and treatment of subpopulations, is crucial to ensuring our patients have the best possible options available to them.”

The survey involved oncologists who practice in a variety of settings ranging from private practice and community hospitals to national cancer centers from 37 different states. It identified considerable gaps where further research is needed to improve the landscape of advanced NSCLC, specifically relating to available treatment options, biomarker testing and subpopulations.

The majority of oncologists (96%) agree that it is important to have multiple treatment options available for their patients, which is important as high percentages of comorbidities and other clinical characteristics can make managing advanced NSCLC more challenging.

• Of the advanced NSCLC patients seen in daily practice, oncologists reported that they most commonly see patients with high blood pressure on average (45% of their advanced NSCLC patients) and when thinking specifically about location of metastases, lymph nodes appear to be most common site (48% of their advanced NSCLC patients on average).
• More than 4 in 5 oncologists (86%) feel that patients whose advanced NSCLC has metastasized to their brain are very/somewhat difficult to treat, and 75% feel that way about disease that has metastatized to patients’ bones.
• The majority of oncologists (88%) agree that more clinical research is necessary to treat advanced NSCLC patients with comorbidities.
• Oncologists reported that treatment efficacy (93%), biomarkers (86%) and potential side effects or safety (83%) are very important/absolutely essential considerations when making treatment decisions for patients with advanced NSCLC.
• 94% of oncologists believe that it’s important to have patients involved in treatment decisions.

On the topic of immunotherapy, oncologists reported that they use these treatments frequently in their practice in first- and second-line advanced NSCLC but agree more research would be helpful.

• 71% of oncologists are most interested in additional research being conducted on combination treatments involving immunotherapy for advanced NSCLC
• Despite 97% and 86% oncologists reporting that any of their advanced NSCLC patients receive immunotherapy treatment in the first- or second-line, respectively, nearly one third of oncologists (30%) believed there is room for more immunotherapy options for advanced NSCLC, with only 17% describing the current options as excellent.
• Many oncologists reported being very interested in seeing more clinical research on how to treat patients progressing on immuno-oncology therapies (64%) or treatment sequencing strategies (49%).

Oncologists agree (94%) that biomarker testing is essential for determining advanced NSCLC treatment decisions beyond patient stratification, yet a similar proportion (94%) feel that more can be done to improve treatment options for known biomarkers.

• The most common way that oncologists use biomarkers beyond patient stratification is predicting treatment benefit or patient selection (83%).
• More than half of oncologists (59%) would be most interested in more research being conducted on biomarkers to reliably predict treatment response.
• Of the emerging biomarkers included in the survey, KRAS (71%), BRAF (64%) and EGFR (60%) and PD-L1 (60%) were of the most interest, with 62% of oncologists noting they would be interested in more research in this area overall.
• Additionally, oncologists said they would like to see future clinical research of oncologic alterations prioritized for circulating tumor DNA (65%), MET overexpression (47%) and MET amplification (45%).

Oncologists wish they had more clinical research available for several advanced NSCLC subpopulations, specifically noting patients with an ECOG performance status of 2 or higher (59%), patients who are 70+ (47%) and those with metastatic disease (44%) as the groups they were most interested in.

• Many oncologists (82%) agreed that their patients desire more clinical research on advanced NSCLC that is tailored to their personal health history.
• 73% and 75% of oncologists[i] feel there are not enough resources available on the management of patients of color or elderly patients (age 70+) with advanced NSCLC, respectively.
• More than 3 in 5 oncologistsⁱ believe there are not enough resources available on how to manage brain metastases (65%) and cardiovascular disease (63%).

“In our 70-year history as a pioneer of cancer immunology, CRI has been steadfast in our pursuit and discovery of cancer immunotherapy treatments for all cancers,” said CRI’s CEO and Director of Scientific Affairs, Jill O’Donnell-Tormey, Ph.D. “These survey findings demonstrate that oncologists want broader treatment options that can be tailored to their patients to provide the best possible outcome. CRI is looking forward to how we can lead the way in the development of new such immunotherapies for the thousands of patients with advanced non-small cell lung cancer in the U.S.”

More than 238,000 people are diagnosed with lung cancer annually, making it the second most common cancer in the country.[1] About 8 in 10 of those cases are NSCLC, which is typically diagnosed in advanced stages and more challenging to treat.¹

For more information on the survey including additional results, visit www.cancerresearch.org/cri-poll.

About the Survey and Methodology

Healthcare Professional (HCP) Viewpoints: A Poll on Advanced NSCLC Research was conducted online by The Harris Poll on behalf of Regeneron and CRI, among 250 oncologists, hematology/oncologists, and surgical oncologists aged 31 or older practicing in the U.S., are licensed to practice oncology in their state, have a medical degree, and treat a minimum of 10 advanced NSCLC patients in a typical month. The survey was conducted from October 17 to November 8, 2023. Data are weighted where necessary by age and gender to bring them in line with their actual proportions in the population.

Respondents for this survey were selected from among those who have agreed to participate in our surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within + 7.0 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.

All sample surveys and polls, whether they use probability sampling, are subject to other multiple sources of error which are most often not possible to quantify or estimate, including, but not limited to coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments.

About Cancer Research Institute

CRI, established in 1953, is the preeminent U.S. nonprofit organization dedicated exclusively to saving more lives by fueling the discovery and development of powerful immunotherapies for all cancers. Guided by a world-renowned Scientific Advisory Council that includes four Nobel laureates and 33 members of the National Academy of Sciences, CRI has invested over $517 million in support of research conducted by immunologists and tumor immunologists at the world’s leading medical centers and universities and has contributed to many of the key scientific advances that demonstrate the potential for immunotherapy to change the face of cancer treatment. To learn more, go to cancerresearch.org.

[i] Among those who have needed such resources

[1] American Cancer Society. Cancer Facts and Figures. Accessed on December 4, 2023.