Treatment Patterns and Clinical Outcomes Among Metastatic Non–Small-Cell Lung Cancer Patients Treated in the Community Practice Setting

Nadler, Eric; Espirito, Janet L.; Pavilack, Melissa; Boyd, Marley; Vergara-Silva, Andrea; Fernandes, Ancilla W.

doi:10.1016/j.cllc.2018.02.002

Cited by 39 publications

(63 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the treatment patterns observed in the current study reflect the US FDA approval future science group www.futuremedicine.com erlotinib received from 2004 onwards as monotherapy for the treatment of patients with metastatic NSCLC, regardless of genetic mutation status, after failure of at least one prior chemotherapy regimen. The median OS observed in this study (11.1 months from metastatic NSCLC diagnosis and 10.1 months from the start of first-line therapy) was generally consistent with reports in the literature [8,29]. We observed a significant survival benefit with first-line immunotherapy monotherapy compared with first-line chemotherapy/nonimmunotherapy combination therapy and monotherapy (median OS: 17.5 vs 15 months and 6.8 months, respectively).…”

Section: Discussionsupporting

confidence: 91%

“…More than one quarter (26.7%) of patients had no recorded systemic treatments, and the median OS from diagnosis was <1 year. Most patients received first-line platinum-based chemotherapy consistent with both clinical guidelines and other real-world studies conducted during a similar time period [6][7][8]29]. Notably, the current study observed treatment patterns related to the approval and uptake of immunotherapy into clinical practice from 2015 onwards; in the second line of treatment, we observed that nivolumab was initiated after first-line platinum-based chemotherapy in nearly a third of patients.…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Treatment Patterns and Overall Survival in Metastatic Non-Small-Cell Lung Cancer in a Real-World, US Setting

et al. 2019

View full text Add to dashboard Cite

Aim: To conduct a retrospective analysis of electronic medical record data to understand real-world treatment patterns and overall survival (OS) in patients with metastatic non-small-cell lung cancer (NSCLC). Materials & methods: We included n = 9656 adults (≥18 years) with metastatic NSCLC and no prior therapy. Data from 1 January 2013 to 31 January 2017 were analyzed. Results: Carboplatin plus paclitaxel was the most common first-line therapy (18.6%), and nivolumab was the most common second- (31.0%) and third-line (38.4%) therapy; 26.7% of all patients were untreated. Median OS from initial metastatic diagnosis was 11.1 months (95% CI: 10.8–11.5). Second-line immunotherapy extended OS by over 3 months versus second-line chemotherapy. Conclusion: Platinum-based therapy was the most common first-line therapy, and immunotherapy was the most common second- and third-line therapy. Median OS of patients with metastatic NSCLC was <1 year.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 81%

Treatment Patterns and Overall Survival in Metastatic Non-Small-Cell Lung Cancer in a Real-World, US Setting

et al. 2019

View full text Add to dashboard Cite

show abstract

“…These results are similar to those observed in the study conducted by Nadler et al [16], in which 71% of the observed population was initially treated with platinum-based chemotherapy, and to those observed in other smaller published real-world utilization studies of similar time frames reporting ranges from 61 to 85% utilization of platinum-based chemotherapy as first line-treatment [17,18]. However, within the scenario of second-line treatment, the use of docetaxel in our study was much higher than that observed in the aforementioned studies, being used in 47% of our patients versus the observed range of 14-16% [16,17].…”

Section: Discussionsupporting

confidence: 93%

“…EGFR mutation was tested in 73.9% of our population and was positive in 36.5% of these patients; ALK translocation was tested in 11.3% and was positive in 15.4%. In the study by Nadler et al [16] in the USA, EGFR and ALK status was available in approximately 40% and 35% of the patients, respectively. Among those with documented results, EGFR and ALK status was positive in 13% and 3% of the patients, respectively [16].…”

Section: Discussionmentioning

confidence: 99%

Treatment Patterns and Costs Associated with Stage IV Non-Small Cell Lung Cancer in a Mexican Population: A Chart Review

Alatorre¹,

Campos-Gómez

Mora³

et al. 2019

PharmacoEconomics Open

View full text Add to dashboard Cite

Background The available evidence regarding the clinical characteristics, treatment patterns, adverse events (AEs), and costs of treating patients with stage IV non-small cell lung cancer (NSCLC) in Mexico is scarce. Objective Our objective was to describe the clinical characteristics, treatment patterns, and direct costs associated with Mexican patients diagnosed with stage IV NSCLC who had completed two or more lines of systemic antineoplastic treatment. Methods A multicenter retrospective cohort study was designed to collect data from the medical records of patients treated at tertiary-level public hospitals in Mexico (multicenter chart review). We calculated costs from the viewpoint of payers based on data regarding therapy and service utilization. Results A total of 115 patients were included. Median patient age was 61 years (interquartile range [IQR] 52.4-68.5), and 51.3% were female. The most common NSCLC type was non-squamous (92.2%), and the typical histology was adenocarcinoma (88.7%). All patients received first-and second-line therapy: 54.78% completed a third-line, 27.82% a fourth-line, 7.82% a fifth-line, 2.6% a sixth-line, and 1.7% a seventh-line active therapy. Carboplatin was the most frequently used therapy (28.6%) followed by docetaxel (23.3%), nivolumab (16.7%), and irinotecan (13.3%). AEs occurred in 53% of the patients and none was fatal. In total, 59 patients (51.3%) required hospitalization during the observation period. The median cost per patient was $US7039.40, with a minimum of $US628.30 and a maximum of $US3,557,364.20. Median overall survival of the cohort was 12 months (95% confidence interval 9.8-14.1). Conclusions In Mexico, NSCLC is usually diagnosed at stage IV. This study shows considerable variation in chemotherapy regimens, leading to a wide range in treatment cost. The understanding of NSCLC treatment patterns in Mexico will help to identify and address unmet needs.

show abstract

“…Likewise, even in current study, Pemetrexed (30.3%, 22.7%) and Cisplatinum (23.9%, 13.6%) were the most frequently used chemotherapeutic drugs as 1st and 2nd line, respectively whereas, among TKIs, Ge tinib (31.5%, 17.4%) and Icotinib (20.3%, 15.9%) were the frequently used treatment in 1st and 2nd line, respectively. This treatment pattern is not in line with other patterns reported elsewhere wherein docetaxel was used in 14.0-16.0% of patients in 2nd line (25,26).…”

Section: Discussioncontrasting

confidence: 82%

Treatment Pattern and Overall Survival of Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicentric Real-World Study in China (CTONG1506)

Zhou

Song

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background:CTONG1506, an observational study assessed the real-world treatment patterns and overall survival (OS) of Chinese advanced non-squamous non-small cell lung cancer (NSCLC) patients in current treatment practices.Methods:Patients initiated with 1st line therapy were identified from 12 tertiary hospitals across China. Survival data were collected 1- and 2-years after study initiation. OS was estimated using the Kaplan-Meier method.Results:Among 540 patients with survival data, median OS was 21.4 months (95% CI: 18.1–25.5), and 2-year OS rate was 46.3% (95% CI: 42.0%-51.0%). Median OS for patients with epidermal growth factor receptor (EGFR+) mutation (n = 203), anaplastic lymphoma kinase (ALK+) rearrangement (n = 24), EGFR-/ALK- were 27.9 months (95% CI: 23.4-NA), 24.5 months (95% CI: 18.1-NA), and 15.7 (95% CI: 13.1–21.1) months, respectively. Median OS was not reached in EGFR exon 19 deletion patients compared to EGFR exon 21 L858R mutation patients (21.4 months, 95% CI: 16.7–35.6, P = 0.038). 93 EGFR + patients received tyrosine kinase inhibitor (TKI) alone, 21 received chemotherapy alone and 66 received TKI and chemotherapy [median OS 25.5 months, 18.1 months, and 35.6 months, respectively]. For EGFR + patients, TKI alone was the preferred therapy in 1st (58.2%) and 2nd (56.8%) line when compared to chemotherapy (35.1% and 31.1% respectively). In 3rd line, chemotherapy was preferred (46.0%) over TKI only (38.0%) in these patients.ConclusionsOS for patients with advanced non-squamous NSCLC patients aligned with previous trials. EGFR + patients who received both TKI and chemotherapy had longer median OS, which is consistent with results from other trials.

show abstract

Treatment Patterns and Clinical Outcomes Among Metastatic Non–Small-Cell Lung Cancer Patients Treated in the Community Practice Setting

Cited by 39 publications

References 15 publications

Treatment Patterns and Overall Survival in Metastatic Non-Small-Cell Lung Cancer in a Real-World, US Setting

Treatment Patterns and Overall Survival in Metastatic Non-Small-Cell Lung Cancer in a Real-World, US Setting

Treatment Patterns and Costs Associated with Stage IV Non-Small Cell Lung Cancer in a Mexican Population: A Chart Review

Treatment Pattern and Overall Survival of Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicentric Real-World Study in China (CTONG1506)

Contact Info

Product

Resources

About