Cargando…
Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases
BACKGROUND: Most patients with epidermal growth factor receptor mutation-positive (EGFRm) non-small-cell lung cancer (NSCLC) acquire resistance to first-line (1L) first- or second-generation (1G/2G) EGFR-TKIs; therefore, it is important to optimize 1L treatment to improve patient outcomes. OBJECTIVE...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844326/ https://www.ncbi.nlm.nih.gov/pubmed/34510401 http://dx.doi.org/10.1007/s40801-021-00272-5 |
_version_ | 1784651448495112192 |
---|---|
author | Soo, Ross A. Seto, Takashi Gray, Jhanelle E. Thiel, Ellen Taylor, Aliki Sawyer, William Karimi, Parisa Marchlewicz, Elizabeth Brouillette, Matthew |
author_facet | Soo, Ross A. Seto, Takashi Gray, Jhanelle E. Thiel, Ellen Taylor, Aliki Sawyer, William Karimi, Parisa Marchlewicz, Elizabeth Brouillette, Matthew |
author_sort | Soo, Ross A. |
collection | PubMed |
description | BACKGROUND: Most patients with epidermal growth factor receptor mutation-positive (EGFRm) non-small-cell lung cancer (NSCLC) acquire resistance to first-line (1L) first- or second-generation (1G/2G) EGFR-TKIs; therefore, it is important to optimize 1L treatment to improve patient outcomes. OBJECTIVE: To retrospectively examine treatment patterns in locally advanced/metastatic NSCLC using MarketScan(®) Commercial and Medicare Supplemental Databases (all US census regions). PATIENTS AND METHODS: Adults with a lung cancer diagnosis code between 1 January 2015–31 March 2018 were analyzed from diagnosis (index) through a variable-length follow-up. Patients had ≥ 1 pharmacy claim for 1G/2G EGFR-TKIs on or within 60 days post-index. Data were stratified by presence or absence of central nervous system (CNS) metastases (30 days pre-index through study end). RESULTS: 578 patients were included (median age 63 years, 64% female). Median follow-up was 13.5 months. The most frequently prescribed 1L EGFR-TKI was erlotinib (414/578, 72%). Median time to 1L treatment discontinuation was 8.2 (95% confidence interval (CI) 6.9, 9.0) months in patients diagnosed with CNS metastases at any time, and 7.7 (95% CI 6.9, 8.9) months in patients without CNS metastases. 270/578 patients (47%) discontinued 1L EGFR-TKIs; 209/270 (77%) initiated second-line (2L) therapy, most frequently osimertinib (96/209, 46%). CONCLUSIONS: In an analysis of US claims data, nearly half of patients discontinued 1L EGFR-TKIs, and 46% who initiated 2L received osimertinib. As nearly a quarter of patients who discontinued 1L EGFR-TKIs did not receive 2L treatment, this study highlights the need for optimal 1L treatment in EGFRm locally advanced/metastatic NSCLC. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40801-021-00272-5. |
format | Online Article Text |
id | pubmed-8844326 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-88443262022-02-23 Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases Soo, Ross A. Seto, Takashi Gray, Jhanelle E. Thiel, Ellen Taylor, Aliki Sawyer, William Karimi, Parisa Marchlewicz, Elizabeth Brouillette, Matthew Drugs Real World Outcomes Original Research Article BACKGROUND: Most patients with epidermal growth factor receptor mutation-positive (EGFRm) non-small-cell lung cancer (NSCLC) acquire resistance to first-line (1L) first- or second-generation (1G/2G) EGFR-TKIs; therefore, it is important to optimize 1L treatment to improve patient outcomes. OBJECTIVE: To retrospectively examine treatment patterns in locally advanced/metastatic NSCLC using MarketScan(®) Commercial and Medicare Supplemental Databases (all US census regions). PATIENTS AND METHODS: Adults with a lung cancer diagnosis code between 1 January 2015–31 March 2018 were analyzed from diagnosis (index) through a variable-length follow-up. Patients had ≥ 1 pharmacy claim for 1G/2G EGFR-TKIs on or within 60 days post-index. Data were stratified by presence or absence of central nervous system (CNS) metastases (30 days pre-index through study end). RESULTS: 578 patients were included (median age 63 years, 64% female). Median follow-up was 13.5 months. The most frequently prescribed 1L EGFR-TKI was erlotinib (414/578, 72%). Median time to 1L treatment discontinuation was 8.2 (95% confidence interval (CI) 6.9, 9.0) months in patients diagnosed with CNS metastases at any time, and 7.7 (95% CI 6.9, 8.9) months in patients without CNS metastases. 270/578 patients (47%) discontinued 1L EGFR-TKIs; 209/270 (77%) initiated second-line (2L) therapy, most frequently osimertinib (96/209, 46%). CONCLUSIONS: In an analysis of US claims data, nearly half of patients discontinued 1L EGFR-TKIs, and 46% who initiated 2L received osimertinib. As nearly a quarter of patients who discontinued 1L EGFR-TKIs did not receive 2L treatment, this study highlights the need for optimal 1L treatment in EGFRm locally advanced/metastatic NSCLC. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40801-021-00272-5. Springer International Publishing 2021-09-12 /pmc/articles/PMC8844326/ /pubmed/34510401 http://dx.doi.org/10.1007/s40801-021-00272-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Article Soo, Ross A. Seto, Takashi Gray, Jhanelle E. Thiel, Ellen Taylor, Aliki Sawyer, William Karimi, Parisa Marchlewicz, Elizabeth Brouillette, Matthew Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases |
title | Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases |
title_full | Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases |
title_fullStr | Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases |
title_full_unstemmed | Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases |
title_short | Treatment Patterns in Patients with Locally Advanced or Metastatic Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: Analysis of US Insurance Claims Databases |
title_sort | treatment patterns in patients with locally advanced or metastatic non-small-cell lung cancer treated with epidermal growth factor receptor-tyrosine kinase inhibitors: analysis of us insurance claims databases |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844326/ https://www.ncbi.nlm.nih.gov/pubmed/34510401 http://dx.doi.org/10.1007/s40801-021-00272-5 |
work_keys_str_mv | AT soorossa treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT setotakashi treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT grayjhanellee treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT thielellen treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT tayloraliki treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT sawyerwilliam treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT karimiparisa treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT marchlewiczelizabeth treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases AT brouillettematthew treatmentpatternsinpatientswithlocallyadvancedormetastaticnonsmallcelllungcancertreatedwithepidermalgrowthfactorreceptortyrosinekinaseinhibitorsanalysisofusinsuranceclaimsdatabases |