{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:18:57Z","timestamp":1787807937457,"version":"build-2784847793"},"reference-count":11,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002192","name":"LUNGevity Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002192","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011957","name":"Takeda Oncology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Determining lines of therapy (LOT) using real\u2010world data is crucial to inform clinical decisions and support clinical research. Existing rules for determining LOT in patients with metastatic non\u2010small cell lung cancer (mNSCLC) do not incorporate the growing number of targeted therapies used in treatment today. Therefore, we propose rules for determining LOT from real\u2010world data of patients with mNSCLC treated with targeted therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>LOT rules were developed through expert consensus using a real\u2010world cohort of 550 patients with <jats:italic>ALK<\/jats:italic>+ or <jats:italic>ROS1<\/jats:italic>+ mNSCLC in the multi\u2010institutional, electronic medical record\u2010based Academic Thoracic Oncology Medical Investigators Consortium's (ATOMIC) Driver Mutation Registry. Rules were subsequently modified based on a review of appropriate LOT determination. These resulting rules were then applied to an independent cohort of patients with <jats:italic>EGFR<\/jats:italic>+ mNSCLC to illustrate their use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six rules for determining LOTs were developed. Among 1133 patients with <jats:italic>EGFR<\/jats:italic> mutations and mNSCLC, a total of 3168 regimens were recorded with a median of 2 regimens per patient (IQR, 1\u20134; range, 1\u201313). After applying our rules, there were 2834 total LOTs with a median of 2 LOTs per patient (IQR, 1\u20133; range, 1\u201311). Rules 1\u20133 kept 11% of regimen changes from advancing the LOT. When compared to previously published rules, LOT assignments differed 5.7% of the time, mostly in LOTs with targeted therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These rules provide an updated framework to evaluate current treatment patterns, accounting for the increased use of targeted therapies in patients with mNSCLC, and promote standardization of methods for determining LOT from real\u2010world data.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70049","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T01:59:22Z","timestamp":1732586362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Determining Line of Therapy from Real\u2010World Data in Non\u2010Small Cell Lung Cancer"],"prefix":"10.1002","volume":"33","author":[{"given":"Connor B.","family":"Grady","sequence":"first","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Ting","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua E.","family":"Reuss","sequence":"additional","affiliation":[{"name":"Department of Medicine Georgetown University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wade","family":"Iams","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Cass","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devalben","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen V.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine Georgetown University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Liliana Bravo","family":"Montenegro","sequence":"additional","affiliation":[{"name":"Department of Medicine Georgetown University  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejas","family":"Patil","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine University of Colorado Cancer Center  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge J.","family":"Nieva","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Southern California\/Norris Comprehensive Cancer Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Southern California\/Norris Comprehensive Cancer Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen A.","family":"Marrone","sequence":"additional","affiliation":[{"name":"Department of Oncology Johns Hopkins University School of Medicine  Baltimore 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey Leigh","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine Lineberger Comprehensive Cancer Center  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Medicine Lineberger Comprehensive Cancer Center  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangdi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Medicine UCSF School of Medicine, University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vamsidhar","family":"Velcheti","sequence":"additional","affiliation":[{"name":"Department of Medicine NYU Grossman School of Medicine  New York New York 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