The targeted therapy with tyrosine kinase inhibitors (TKIs) against the epidermal growth factor receptor mutation (EGFRm) in advanced non-small cell lung cancer (NSCLC) changed the treatment paradigm. REFLECT study (NCT04031898) explored EGFR/T790M testing and treatment patterns in EGFRm NSCLC patients receiving first- or second-generation (1G/2G) EGFR TKIs as front-line (1L) in eight countries. Pooled data from Central Eastern Europe (CEE) countries from this study (Bulgaria, Poland, Romania, Slovenia) are presented here. This physician-led chart review study was conducted in patients with confirmed-EGFRm NSCLC initiating 1L 1G/2G EGFR TKIs between 2015–2018. The CEE cohort included 389 patients receiving 1L erlotinib (37%), afatinib (34%), and gefitinib (29%). Overall, 320 (82%) patients discontinued 1L, and 298 (77%) progression events were registered. Median progression free survival on 1L TKIs was 14.0 (95% CI: 12.6–15.6) months. Median overall survival from 1L start was 26.6 (95% CI: 24.1–29.0) months. Attrition rate between 1L and next line was 30%. Among patients with 1L progression, 200 (67%) were tested for T790M and 58% were positive. This first CEE analysis of treatments and outcomes in EGFRm NSCLC patients highlights the importance of using the most efficacious therapies currently available in 1L to reduce attrition and improve patient outcomes.

Radiotherapy (RT) plays a crucial role in all stages of lung cancer. Data on recent real-world RT patterns and main drivers of RT decisions in lung cancer in Romania is scarce; we aimed to address these knowledge gaps through this physician-led medical chart review in 16 RT centers across the country. Consecutive patients with lung cancer receiving RT as part of their disease management between May–October 2019 (pre-COVID-19 pandemic) were included. Descriptive statistics were generated for all variables. This cohort included 422 patients: median age 63 years, males 76%, stages I–II 6%, III 43%, IV 50%, mostly adeno- and squamous cell carcinoma (76%), ECOG 0-1 50% at the time of RT. Curative intent RT was used in 36% of cases, palliative RT in 64%. Delays were reported in 13% of patients, mostly due to machine breakdown (67%). Most acute reported RT toxicity was esophagitis (19%). Multiple disease-, patient-, physician- and context-related drivers counted in the decision-making process. This is the first detailed analysis of RT use in lung cancer in Romania. Palliative RT still dominates the landscape. Earlier diagnosis, coordinated multidisciplinary strategies, and the true impact of the multimodal treatments on survival are strongly needed to improve lung cancer outcomes.

Background/Objectives: The outcomes of biologics in severe eosinophilic asthma (SEA) in real-world settings are less known. We describe the SEA population, treatment patterns, and outcomes following benralizumab authorization in Romania. Methods: BREEZE was a retrospective chart review study with a pre–post design conducted in five Central Eastern European and Baltic countries, including Romania (July 2022–January 2023). Adult SEA patients receiving ≥1 benralizumab dose in routine care were enrolled with up to 56 weeks (W) follow-up after benralizumab initiation. Using a funnel approach, the number of patients decreased throughout the follow-up; changes from baseline were tested in patients with available data. Results: The Romanian cohort included 131 patients (mean age: 54.4 years at benralizumab initiation; 66% females). Half of patients (53%) received 8 benralizumab doses; only 3 discontinued treatment. At benralizumab initiation, 15% were on maintenance oral corticosteroids (mOCS, median dose: 12.5 mg/day prednisone-equivalent; 17/20 patients > 5 mg/day). At W48, 11.4% of 70 patients with available data continued using mOCS (median dose: 5 mg/day; 3/8 > 5 mg/day). The annualized exacerbation rate was 2.61 (95%CI: 2.28–2.98) at baseline, reducing by 89% at W16 and 90% at W48. Blood eosinophils decreased early from a median of 620 cells/μL (94/120 > 400 cells/μL) at baseline to 1 cell/μL at W16 (n = 36; p < 0.001). FEV₁ increased from 1.8 L at baseline to 2.06 L at W16 (n = 59; p < 0.001), 2.15 L at W24 (n = 51; p < 0.001), and 1.96 L at W48 (n = 31; p = 0.002). Most patients had poorly controlled asthma (103 with ACT < 16) at baseline; score increased >9 points at W16 (n = 81; p < 0.001), W24 (n = 80; p < 0.001), and W48 (n = 55; p = 0.002). Conclusions: Our national cohort contributes to the increasing evidence on the meaningful results of benralizumab in SEA patients treated in routine practice.