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...

Descripción completa

Detalles Bibliográficos
Autores principales: Soo, Ross A., Seto, Takashi, Gray, Jhanelle E., Thiel, Ellen, Taylor, Aliki, Sawyer, William, Karimi, Parisa, Marchlewicz, Elizabeth, Brouillette, Matthew
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