Access to Tyrosine Kinase Inhibitors and Survival in Patients with Advanced EGFR+ and ALK+ Positive Non–small-cell Lung Cancer Treated in the Real-World

2021 ◽  
Author(s):  
Bernardo H.L. Goulart ◽  
Shasank Chennupati ◽  
Catherine R. Fedorenko ◽  
Scott D. Ramsey
Keyword(s):  
Lung Cancer ◽  
Tyrosine Kinase ◽  
Small Cell Lung Cancer ◽  
Tyrosine Kinase Inhibitors ◽  
Cell Lung Cancer ◽  
Real World ◽  
Kinase Inhibitors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Alk Positive

scholarly journals Out-of-Pocket Costs for Tyrosine Kinase Inhibitors and Patient Outcomes in EGFR- and ALK-Positive Advanced Non–Small-Cell Lung Cancer

2020 ◽  
pp. OP.20.00692 ◽  
Author(s):  
Bernardo H.L. Goulart ◽  
Joseph M. Unger ◽  
Shasank Chennupati ◽  
Catherine R. Fedorenko ◽  
Scott D. Ramsey
Keyword(s):  
Lung Cancer ◽  
Tyrosine Kinase ◽  
Small Cell Lung Cancer ◽  
Tyrosine Kinase Inhibitors ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Alk Positive ◽  
Tki Discontinuation

PURPOSE: We investigated the association of out-of-pocket (OOP) costs for tyrosine kinase inhibitors (TKIs) with overall survival (OS) in epidermal growth factor receptor ( EGFR)- and anaplastic lymphoma kinase ( ALK)-positive advanced non–small-cell lung cancer (NSCLC). We secondarily investigated associations of TKI OOP costs with TKI adherence, duration of therapy (DOT), and TKI discontinuation. METHODS: We used the Hutchinson Institute for Cancer Outcomes Research registry-claims database to identify patients with stage IV EGFR- or ALK-positive NSCLC; ≥ 1 claims for EGFR or ALK TKIs; and ≥ 3-month survival from TKI initiation. We estimated the average monthly TKI OOP costs per patient up to 3 months from TKI initiation, categorizing patients into quartiles of TKI OOP costs (Q1 < Q2 < Q3 < Q4). We conducted landmark analysis at 3 months from TKI initiation to compare Q1-3 v Q4 TKI OOP costs with respect to OS, TKI DOT, TKI adherence, and TKI discontinuation. RESULTS: Seventy-eight and twenty-seven patients comprised the Q1-3 and Q4 groups, respectively. Median monthly TKI OOP costs were $1,431 (Q1-3) v $2,888 (Q4). Compared with Q1-3, Q4 patients had inferior OS (adjusted hazard ratio [HR], 1.85; [95% CI, 1.11 to 3.10], similar TKI DOT (adjusted HR, 1.06; 95% CI, 0.53 to 2.15), decreased TKI adherence (adjusted odds ratio [OR], 0.28; 95% CI, 0.10 to 0.76), and higher TKI discontinuation rate (adjusted OR, 8.75; 95% CI, 2.59 to 29.52). CONCLUSION: Among patients with advanced EGFR- and ALK-positive NSCLC, higher TKI OOP costs are associated with decreased TKI adherence, a higher likelihood of TKI discontinuation, and inferior survival.

scholarly journals Interstitial Lung Disease Induced by Crizotinib in Non-Small-Cell Lung Cancer

2019 ◽  
Vol 32 (3) ◽  
pp. 236 ◽  
Author(s):  
Andreia Tereso ◽  
Luís Carreto ◽  
Manuela Baptista ◽  
Maria Amélia Almeida
Keyword(s):  
Lung Cancer ◽  
Interstitial Lung Disease ◽  
Tyrosine Kinase ◽  
Small Cell Lung Cancer ◽  
Lung Disease ◽  
Tyrosine Kinase Inhibitors ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Small Cell ◽  
Small Cell Lung

The treatment of advanced non-small-cell lung cancer shifted with the development of molecular-targeted therapies, like the tyrosine kinase inhibitors. One example of tyrosine kinase inhibitors is crizotinib, an anaplastic lymphoma tyrosine kinase inhibitor, which targets an echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase gene fusion. This mutation is found in only 2% to 7% of non-small-cell lung cancer cases. Although these new therapies have shown promising results, the occurrence of interstitial lung disease as a side effect could be problematic. As the diagnosis of drug-related-interstitial lung disease is difficult to make, computed tomography is an important diagnostic tool. The recognition of computed tomography manifestations of tyrosine kinase inhibitors -induced interstitial lung disease is the key for an early recognition and management of this pulmonary toxicity. We aim to raise awareness of tyrosine kinase inhibitors-induced interstitial lung disease, by reporting the first case of a Portuguese patient treated with crizotinib for non-small-cell lung cancer who developed drug-induced interstitial lung disease.

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