Characterization and economic burden of KRASG12C-mutant lung cancer in real-world Spanish practice: a retrospective observational study (SILK study)

Introduction

Real-world evidence on the direct healthcare costs of patients with KRASG12C-mutant non-small-cell lung cancer (NSCLC) is limited.

Material and Methods

Multicenter, observational, retrospective study in patients newly diagnosed with advanced-stage NSCLC harboring the KRASG12C mutation within real-world clinical practice in Spain. Patient characteristics, treatment patterns, outcomes, and direct healthcare costs were collected from medical records and administrative databases between January 1, 2016, and March 9, 2022.

Results

127 patients were included in the study, with global and disease-related economic data available for 125 and 104 patients, respectively. Most patients (97.6%) were current or former smokers. The most prevalent co-mutations or genetic alterations at baseline involved TP53 (38.2%), ATM (20.0%), and STK11 (15.4%) genes. 94 patients (74.0%) received systemic therapy. Chemotherapy was the most common first-line (63.8%) and immunotherapy the most common second-line therapy (64.6%). Median progression-free survival (95% CI) for the first, second and third treatment lines was 4.6 (2.8–7.8), 3.8 (1.5–8.2), and 2.2 (0.1–9.9) months, respectively. Median overall survival (95% CI) was 7.7 (4.9–11.0), 9.0 (3.0–14.3), and 8.9 (0.1–19.7) months, respectively. Total global cost over the study period amounted to €5,706,820 (€46,023 per patient), with pharmacological costs totaling €2,353,299 (€18,978 per patient). Disease-related costs were €4,219,410 (€40,965 per patient), with disease-related pharmacological costs of €2,157,627 (€20,948 per patient).

Conclusion

These real-world data highlight the limited outcomes for most NSCLC patients with KRASG12C mutations, underscoring the significant clinical and economic burden associated with their care. The evaluation of the impact of novel and effective targeted therapies is therefore warranted.