Physician Views: Is Keytruda use in first-line NSCLC having any impact on second-line treatment trends?

As a companion piece to our recent survey looking at initial use of Keytruda in first-line NSCLC patients (Physician Views Poll Results: Merck & Co.'s Keytruda gaining traction in first-line NSCLC say oncologists), our last Physician Views poll of 2016 assesses how approval of Merck & Co.'s PD-1 inhibitor in the front-line setting is impacting use of immunotherapy in second-line patients.

Since approval last year, Bristol-Myers Squibb's competing PD-1 inhibitor Opdivo has dominated the second-line NSCLC market, thanks largely to a broad label which does not require PD-L1 biomarker testing prior to use. However, with more patients now being tested for PD-L1 status when initially  diagnosed with NSCLC (to assess eligibility for first-line treatment with Keytruda) this commercial dynamic is expected to change. Furthermore, Roche's Tecentriq – a PD-L1 inhibitor offering similar, if not slightly superior, efficacy based on available data – was approved in October for the treatment of second-line NSCLC patients irrespective of PD-L1 status (ViewPoints: Roche's Tecentriq could hit the ground running).

To ascertain whether approval of Keytruda in front-line NSCLC patients is having any impact on second-line treatment trends we are asking US-based oncologists the following questions…

Assuming a first-line NSCLC patient receiving Keytruda monotherapy experienced either progression or recurrence of their disease, would you prescribe another PD-1 or PD-L1 inhibitor as a second-line therapy?

No

Yes – Favour Opdivo

Yes – Favour Tecentriq

Yes – Either Opdivo or Tecentriq

For first-line NSCLC patients who have experienced either progression or recurrence of their disease following treatment with chemotherapy, would you favour a particular PD-(L)1 inhibitor for second-line therapy?

No

Yes – Keytruda

Yes – Opdivo

Yes – Tecentriq

For which reason primarily did you select that product?

Familiarity with use of product/biomarker assay in first-line patients

Familiarity with product in second-line patients

PD-L1 status of patient (i.e. either PD-L1 negative or PD-L1 >1%)

Perception of clinical profile for that product

Dosing regimen for that product

Perception of product manufacturer 

Other (please state)

Do you stratify second-line NSCLC patients by PD-L1 status to determine treatment with a particular product?

No

Yes – 1% or above favour Keytruda / PD-L1 negative favour Opdivo

Yes – 1% or above favour Keytruda / PD-L1 negative favour Tecentriq

Yes – 1% or above favour Keytruda / PD-L1 negative use Opdivo or Tecentriq

In 12 months' time, which of the following PD-(L)1 inhibitor products would you expect to be used most frequently in second-line patients?

Keytruda

Opdivo

Tecentriq

Results and related analysis will be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions. Note: FirstWord Polls are powered by MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at info@firstwordpharma.com

To read more Physician Views articles, click here.