Real-World Outcomes of Selective Inhibitor Selpercatinib in the United States: Descriptive, Retrospective Findings from Two Databases.

Objectives: This study described real-world patient characteristics and outcomes among selpercatinib-treated patients in the United States, using the Flatiron Health electronic health record-derived deidentified database (FHD) for advanced/metastatic non-small cell lung cancer (a/mNSCLC) and Optum's de-identified Clinformatics Data Mart Database (CDM).

Methods: Patients initiating selpercatinib treatment between 08MAY2020 and 30JUN2023 were included. We evaluated real-world time to selpercatinib treatment discontinuation or death (rwTTDd) and time to next treatment or death (rwTTNTd) using Kaplan-Meier analyses. Medication possession ratio (MPR) was estimated as a measure of medication adherence in CDM patients.

Results: In a/mNSCLC patients from the FHD (N = 68), the median rwTTDd and rwTTNTd were 22.4 [95%CI: 13.3-NR] and 21.0 [95%CI: 11.6-NR] months, respectively. In CDM, these durations were 12.1 [95%CI: 9.6-NR] and 16.2 [95%CI: 9.6-NR] months for lung cancer (n = 43), while these were not reached for thyroid cancer (n = 24) patients. The median MPR was 0.98 [IQR: 0.84-1.00] among all patients in the CDM (N = 75), with 77.3% of patients adhering (MPR ≥ 0.80) to selpercatinib.

Conclusions: Real-world outcomes in this older and frailer patient cohort align with phase 3 trial results, further supporting selpercatinib as the standard of care for patients with -altered cancers. Early testing for the detection of alterations remains essential.