Predictors of Nursing Home Admission, Severe Functional Impairment, or Death One Year After Surgery for Non-Small Cell Lung Cancer

Thirty-eight patients with histologically confirmed non-small-cell lung cancer were treated with bleomycin, vincristin, mitomycin and cisplatin (BOMP) alternated with cyclophosphamide, 4'-epidoxorubicin and procarbazine (CEP). Twenty patients were randomized to start the treatment with BOMP and 18 with CEP. Patients underwent a median of 4 cycles (range, 1-8). The overall response rate was 36% with 2 clinical complete responses. The median duration of response was 6.5 months, the median survival time was 7.5 months, and 37% of patients survived for more than one year. The comparison between the two arms of this study and between this study and a previous investigation on the effectiveness of BOMP suggests that CEP regimen added to BOMP does not significantly improve patient outcome.

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Randomized Phase II Study of Bortezomib Alone and Bortezomib in Combination With Docetaxel in Previously Treated Advanced Non–Small-Cell Lung Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.1853 ◽

2006 ◽

Vol 24 (31) ◽

pp. 5025-5033 ◽

Cited By ~ 100

Author(s):

Michael P. Fanucchi ◽

Frank V. Fossella ◽

Robert Belt ◽

Ronald Natale ◽

Panos Fidias ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Single Agent ◽

Small Cell ◽

Small Cell Lung ◽

Randomized Phase Ii ◽

Common Grade ◽

Grade 3 ◽

One Year

Purpose To evaluate the efficacy and toxicity of bortezomib ± docetaxel as second-line therapy in patients with relapsed or refractory advanced non–small-cell lung cancer (NSCLC). Patients and Methods Patients were randomly assigned to bortezomib 1.5 mg/m2 (arm A) or bortezomib 1.3 mg/m2 plus docetaxel 75 mg/m2 (arm B). A treatment cycle of 21 days comprised four bortezomib doses on days 1, 4, 8, and 11, plus, in arm B, docetaxel on day 1. Patients could receive unlimited cycles. The primary end point was response rate. Results A total of 155 patients were treated, 75 in arm A and 80 in arm B. Baseline characteristics were comparable. Investigator-assessed response rates were 8% in arm A and 9% in arm B. Disease control rates were 29% in arm A and 54% in arm B. Median time to progression was 1.5 months in arm A and 4.0 months in arm B. One-year survival was 39% and 33%, and median survival was 7.4 and 7.8 months in arms A and B, respectively. Adverse effect profiles were as expected in both arms, with no significant additivity. The most common grade ≥ 3 adverse events were neutropenia, fatigue, and dyspnea (4% and 53%, 19% and 26%, and 17% and 14% of patients in arms A and B, respectively). Conclusion Bortezomib has modest single-agent activity in patients with relapsed or refractory advanced NSCLC using this schedule, with minor enhancement in combination with docetaxel. Additional investigation of bortezomib in NSCLC is warranted in combination with other drugs known to be active, or using different schedules.

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CT14 PREDICTING ONE-YEAR SURVIVAL AFTER SURGERY FOR EARLY STAGE NON-SMALL CELL LUNG CANCER

ANZ Journal of Surgery ◽

10.1111/j.1445-2197.2007.04115_14.x ◽

2007 ◽

Vol 77 (s1) ◽

pp. A10-A11

Author(s):

M. O?keefe ◽

C. H. Yap ◽

A. Lee ◽

K. Kiyingi ◽

N. Alam ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

One Year

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Costs of Extended Use of the Immune Check Point Inhibitors in 1st-line Non-Small Cell Lung Cancer

Journal of Clinical and Medical Research ◽

10.37191/mapsci-2582-4333-3(5)-086 ◽

2021 ◽

Author(s):

Helmy M Guirgis

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Check Point ◽

Small Cell Lung ◽

Curative Intent ◽

Check Point Inhibitors ◽

One Year ◽

The Impact

Aim: Cost-effectiveness in the health care system has been extensively investigated. Reports, however, on costs and the impact of extended use of the immune check point inhibitors (ICI) are rare. Pembrolizumab (Pembro) improved the 5-year overall survival in1st-line advanced/metastatic non-small cell lung cancer a/m-NSCLC. ICI are rather expensive, and costs are bound to increase with prolonged therapy. We purposed to focus on cost of extended ICI use beyond their indications in a/m-NSCLC. Methods: The 2020 annual posted drug costs were calculated in US$. Except for the one-year adjuvant Durv, used for curative intent, ICI costs were calculated for 2-years and beyond. Adverse events-treatment costs and generic chemo-drugs were not included. Results: ICI costs ranged from $103,400 to $168,948 with $148,431 mean. Adjuvant Durv one-year costs were $148,013. The 2-year Pembro costs in PD-L1 > 50% were $334,652, multiplying to >$836,630 after 5 years. Addition of 4 Peme cycles improved outcome regardless of PD-L1 at costs of $360,912. Costs of the 2-year Atezolizumab/Bevacizumab (Atezo/Bev) and one-year Peme were $722,977. Use of Biosimilar (Bio) saved $77,120. Atezo-Peme without Bev reduced costs to $422,725. Costs of Ipilimumab/Nivolumab (Ipi/Nivo) were $544,696. Adding 2 Peme cycles increased costs to $557,826. Extended for 6 months, the 2-year-costs of the 3 ICI combinations increased by 25% of the maintenance ICI. As compared with Pembro-Peme, the 2-year costs of Atezo/Bio-Bev-Peme were 2.00 higher, Atezo-Bio-Bev-Peme 1.79, Atezo-Pem 1.17, Ipi/Nivo 1.51 and Ipi/Nivo-Peme 1.55. The ratios would further separate with extended use beyond 2 years. Conclusions: ICI costs are determined by duration of therapy more than by the posted annual price. Costs of extended use call for guidance on therapy duration and emphasize the need for cost constraint-policies.

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