Assessing functional status and the survival benefit of chemotherapy for advanced non-small cell lung cancer using administrative claims data

Feliciano, Josephine; Gardner, Lisa; Hendrick, Franklin; Edelman, Martin J.; Davidoff, Amy J.

doi:10.1016/j.lungcan.2014.10.011

Cited by 12 publications

(13 citation statements)

References 20 publications

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“…In addition to evaluating individual symptoms using multiple dimensions, we found that lung cancer patients with lower functional status, who are less likely to benefit from CTX [27], were more likely to report higher global distress, physical, and psychological symptoms one week after CTX administration. Functional status is associated with several important outcomes in cancer patients including CTX toxicity, benefit from CTX, and overall survival [27–29].…”

Section: Discussionmentioning

confidence: 99%

“…Functional status is associated with several important outcomes in cancer patients including CTX toxicity, benefit from CTX, and overall survival [27–29]. Previous studies have demonstrated an association between patient-reported functional status and increased morning and evening fatigue [18,30], cancer pain [31], and a subgroup of patients who reported higher occurrence rates for multiple symptoms [5].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy

Wong

Paul

Cooper

et al. 2017

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Purpose Few studies have examined inter-individual variability in the symptom experience of lung cancer patients. We aimed to identify the most prevalent, severe, and distressing symptoms, and risk factors associated with increased symptom burden. Methods Lung cancer patients (n=145) reported occurrence, severity, and distress for 38 symptoms on the Memorial Symptom Assessment Scale one week after chemotherapy. Using multidimensional subscales, risk factors for higher global distress, physical, and psychological symptoms were evaluated using simultaneous linear regression. Results Mean age was 64.0 years and 56.6% were female. Mean Karnofsky Performance Status score was 79.1 (SD 14.6) and mean Self-Administered Comorbidity Questionnaire score was 7.3 (SD 3.9). The most distressing and prevalent symptom was fatigue. Problems with sexual interest/activity had the highest mean severity rating. Patients with lower functional status (p=0.001) and higher comorbidity (p=0.02) reported higher global distress. Similarly, lower functional status (p=0.003) and higher comorbidity (p=0.04) were associated with a higher physical symptom burden along with lower body mass index (p=0.02). Higher psychology symptom burden was associated with lower functional status (p=0.01), younger age (p=0.02), non-metastatic disease (p=0.03), higher number of prior treatments (p=0.04), and income (p=0.03). Conclusions Fatigue was the most distressing and prevalent symptom among lung cancer patients receiving chemotherapy. Lower functional status was associated with a higher burden of global distress, physical, and psychological symptoms. Younger age and non-metastatic disease were additional risk factors for increased psychological symptoms. Together, these risk factors can help clinicians identify lung cancer patients at increased need for aggressive symptom management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy

Wong

Paul

Cooper

et al. 2017

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“…Lung cancer is the leading cause of cancer death in the United States; most patients have distant metastatic disease at diagnosis, and over 150 000 die annually . Although palliative‐intent systemic anticancer therapy is available, estimates of the proportion of patients actually receiving such treatment on a population basis have varied from 26% to 81% . The high proportion of untreated patients likely relates to the fact that the historical backbone of systemic treatment has been cytotoxic chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…1 Although palliative-intent systemic anticancer therapy is available, estimates of the proportion of patients actually receiving such treatment on a population basis have varied from 26% to 81%. [2][3][4][5][6] The high proportion of untreated patients likely relates to the fact that the historical backbone of systemic treatment has been cytotoxic chemotherapy. The median age at lung cancer diagnosis is 70 7 ; for elderly patients with multiple comorbidities, chemotherapy too often confers only a small benefit with substantial toxicity.…”

Section: Introductionmentioning

confidence: 99%

Patterns of care for older patients with stage IV non‐small cell lung cancer in the immunotherapy era

2020

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Background Historically, older patients with advanced lung cancer have often received no systemic treatment. Immunotherapy has improved outcomes in clinical trials, but its dissemination and implementation at the population level is not well‐understood. Methods A retrospective cohort study of patients with stage IV non‐small cell lung cancer (NSCLC) diagnosed age 66 or older from 2012 to 2015 was conducted using SEER‐Medicare. Treatment patterns within one year of diagnosis were ascertained. Outcomes included delivery of (a) any systemic therapy; (b) any second‐line infusional therapy, following first‐line infusional therapy; and (c) any second‐line immunotherapy, following first‐line infusional therapy. Trends in care patterns associated with second‐line immunotherapy approvals in 2015 were assessed using generalized additive models. Sociodemographic and clinical predictors of treatment were explored using logistic regression. Results Among 10 303 patients, 5173 (50.2%) received first‐line systemic therapy, with little change between the years 2012 (47.5%) and 2015 (50.3%). Among 3943 patients completing first‐line infusional therapy, the proportion starting second‐line infusional treatment remained stable from 2012 (30.5%) through 2014 (32.9%), before increasing in 2015 (42.4%) concurrent with second‐line immunotherapy approvals. Factors associated with decreased utilization of any therapy included age, black race, Medicaid eligibility, residence in a high‐poverty area, nonadenocarcinoma histology, and comorbidity; factors associated with increased utilization of any therapy included Asian race and Hispanic ethnicity. Among patients who received first‐line infusional therapy, factors associated with decreased utilization of second‐line infusional therapy included age, Medicaid eligibility, nonadenocarcinoma histology, and comorbidity; Asian race was associated with increased utilization of second‐line infusional therapy. Conclusion United States Food and Drug Administration (FDA) approvals of immunotherapy for the second‐line treatment of advanced NSCLC in 2015 were associated with increased rates of any second‐line treatment, but disparities based on social determinants of health persisted.

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“…Administrative data can provide an effective alternative and has the potential to evaluate functional decline [5][6][7][8][9]. Administrative data offers 'system wide information about health conditions and services in a consistently coded format' [4].…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of the Use of Hospital Administrative Data to Assess Functional Decline

Av¹,

Suliman²,

Vuik³

et al. 2016

J Aging Sci

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Assessing functional status and the survival benefit of chemotherapy for advanced non-small cell lung cancer using administrative claims data

Cited by 12 publications

References 20 publications

Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy

Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy

Patterns of care for older patients with stage IV non‐small cell lung cancer in the immunotherapy era

Systematic Review of the Use of Hospital Administrative Data to Assess Functional Decline

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