Sørup S, Darvalics B, Khalil AA, et al. - In an era when only a minority of patients received programmed cell death-1 and ligand-1 (PD-1/PD-L1) immune checkpoint inhibitors (ICIs), most patients with advanced non-small cell lung cancer (NSCLC), urothelial carcinoma, epithelial ovarian cancer, gastric adenocarcinoma, and renal cell carcinoma (RCC) had poor overall survival (OS). This information on treatment patterns and survival is critical as a real-world baseline before the widespread adoption of ICIs.

• Utilizing nationwide Danish medical registries, the authors gathered cohorts of Danish patients with advanced non-small cell lung cancer (NSCLC) (n = 12,283), urothelial carcinoma (n = 2,504), epithelial ovarian cancer (n = 1,466), gastric adenocarcinoma ( n= 1,457), and renal cell carcinoma (RCC) (n = 1261) diagnosed between January 1, 2013 and December 31, 2017.

• Patients with ovarian cancer (9%) and gastric adenocarcinoma (25%), respectively, did not receive anti-cancer medication.

• Surgery, radiation therapy, and/or medical therapy were given to the remaining patients.

• Except for RCC (tyrosine kinase inhibitors), chemotherapy was the most common medical therapy in all cohorts. In 7–8% of the NSCLC and RCC cohorts, PD-L1/PD-1 ICIs were employed as second or higher line therapies.

• OS was longest in patients who began treatment with surgery (eg 25.6 months for NSCLC and 21.4 months for urothelial carcinoma) and shortest in individuals who began treatment with radiation therapy (eg 3.9 months for NSCLC and 12.6 months for urothelial carcinoma).

• Patients with NSCLC who began medical therapy had an OS between these parameters.

• The median OS for NSCLC patients initiating treatment with PD-L1/PD-1 ICIs was 21.4 months.