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

Real-world data on patients with <i>ROS1</i>-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 <i>ROS1</i>-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 (<i>n</i> = 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 (<i>n</i> = 45) or crizotinib-based regimens (<i>n</i> = 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 (<i>n</i> = 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 <i>ROS1</i>-positive advanced NSCLC. Nevertheless, survival outcomes were limited, highlighting the importance of more effective emerging treatments for <i>ROS1</i>-positive disease.