Clinical characteristics, healthcare resource use, and survival outcomes among patients with advanced NSCLC tested for KRAS mutations in France, the United Kingdom, and Switzerland

To evaluate real-world patient characteristics, healthcare resource use (HRU), and clinical outcomes among patients with advanced or metastatic (A/M) non-small cell lung cancer (NSCLC) stratified by KRAS mutation status (KRAS G12C, KRAS non-G12C, and KRAS wild-type[WT]). This retrospective chart review included adults with A/M NSCLC and known KRAS status who received second- or third-line non-targeted therapy (index therapy) in France, the UK, or Switzerland. Patient characteristics, HRU, and key clinical outcomes—including time to treatment discontinuation (TTD), progression-free survival (PFS), and overall survival (OS)—were analyzed using the Kaplan–Meier method and log-rank methods. Exploratory multivariate Cox models adjusted for clinical covariates. The study included 211 patients (France: 192, UK: 13, Switzerland: 6), with 53.1% having KRAS G12C, 21.8% KRAS non-G12C, and 25.1% KRAS WT NSCLC. Median age was 66 years; 62.1% were male, and 95.8% were current/former smokers. Baseline characteristics were comparable across KRAS subgroups. HRU was high, including 125 unplanned healthcare provider visits, primarily to general practitioners (42.4%) and specialists (24.0%). Hospitalization was frequent (70.1% of patients), with 40.8% experiencing unplanned admissions, largely due to disease complications (54.2%) and grade 3/4 adverse events (24.4%). Median TTD, PFS, and OS were comparable across KRAS subgroups for second-line (4.4–4.7 months, 5.3–6.3 months, and 11.2–15.0 months) and third-line (3.2–4.1 months, 3.4–5.2 months, and 5.1–9.2 months) therapy. Multivariate analysis showed that KRAS status, performance status, histology, and comorbidities were not significantly associated with survival outcomes. Patients with advanced NSCLC, regardless of KRAS mutation status, experience a substantial disease burden, frequent hospitalizations, and poor clinical outcomes. These findings highlight the urgent need for more effective treatment options for advanced NSCLC, including therapies tailored to KRAS-mutated disease. This study looked at people with advanced non-small cell lung cancer (NSCLC) in France, the United Kingdom, and Switzerland who received second- or third-line chemotherapy in 2019. Researchers focused on how often these patients used healthcare services, their clinical characteristics, and their outcomes. Patients were grouped based on whether they had a <i>KRAS</i> gene mutation (<i>KRAS G12C</i>, other <i>KRAS</i> mutations, or no <i>KRAS</i> mutation). The study found that hospitalizations were frequent—both planned and unplanned—and overall survival was poor across all groups. No meaningful differences in survival were observed between the different <i>KRAS</i> subgroups. The analysis also showed that other clinical factors, like performance status or other illnesses, did not significantly affect outcomes. These findings highlight the high disease burden in advanced NSCLC and provide real-world insight into treatment patterns and outcomes before targeted therapies for <i>KRAS</i> mutations were introduced.