Treatment patterns among cancer patients with anemia who do not respond to erythropoietin-stimulating agents.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20525-e20525
Author(s):  
Allicia C Girvan ◽  
Yiu-Keung Lau ◽  
Lee Bowman ◽  
Gerhardt Pohl ◽  
Pamela Landsman-Blumberg ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Response Rate ◽  
Initial Response ◽  
Treatment Patterns ◽  
Small Cell ◽  
Community Practice ◽  
Small Cell Lung ◽  
Response Window ◽  
Response Table

e20525 Background: While broadly utilized for treatment of anemia in cancer patients, treatment with Erythropoetin Stimulating Agents (ESAs) is contraindicated in patients who fail to respond within 6-8 weeks. This study examined rates of ESA response and rates of continued ESA use following non-response in five cancer cohorts treated by community-practice oncologists. Methods: Patients with breast, head and neck, cervical, non-small cell lung cancer, or multiple myeloma initiating ESAs on or before 7/1/2011 were identified from EMRs in the ACORN Data Warehouse (ACORN, Memphis TN). The study included those with at least 6-8 weeks of ESA use and documented hemoglobin (Hb) values ≤28 days before start of ESA (“baseline”) and anytime during day 43-70 of ESA treatment. Per ASCO/ASH guidelines, patients were noted as responders if Hb increased ≥1g/dL between baseline and the Hb value closest to day 56 in the 43-70 day window, and non-responders if Hb increased <1g/dL. Non-responders were further classified as continuing or discontinuing therapy based on record of ESA treatment following determination of non-response. Results: A total of 2,197 patients were studied. ESA response rate was 45%. For non-responders, 83% continued ESAs after determination of non-response. Hb increase at end of therapy among non-responders remained lower than for patients who demonstrated initial response. Additionally, non-responders received nominally longer treatment, with a mean exposure of 169 days. Conclusions: Among cancer patients, a majority of ESA non-responders remained on ESA treatment beyond the recommended response window as defined by ASCO/ASH guidelines. Moreover, non-responders remained on treatment longer than those who demonstrated an initial response. [Table: see text]

Impact of FDA guideline changes on treatment patterns and cost among cancer patients with anemia who do not respond to erythropoietin stimulating agents (ESAs).

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 97-97
Author(s):  
Allicia C. Girvan ◽  
Yiu-Keung Lau ◽  
Gerhardt Pohl ◽  
Pamela Landsman-Blumberg ◽  
Nianwen Shi ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Treatment Patterns ◽  
Small Cell ◽  
Positive Outcomes ◽  
Cost Burden ◽  
Small Cell Lung ◽  
Chi Square ◽  
Chi Square Test ◽  
Response Determination

97 Background: Due to emerging evidence in 2007, the FDA issued warnings in the labeling of ESAs regarding use among cancer patients. Subsequently, ASCO/ASH clinical practice guidelines were also updated to recommend discontinuation of ESAs in patients who fail to respond within 6-8 weeks. Methods: Patients with breast, head and neck, cervical, non-small cell lung cancer, or multiple myeloma initiating ESAs during 1/1/2003 - 7/1/2011 were identified from EMRs in the ACORN Data Warehouse (ACORN, Memphis TN). The study included those with at least 6-8 weeks of ESA use with documented hemoglobin (Hb) values. Following the ASCO/ASH guidelines, patients were defined as non-responders if Hb increased < 1g/dL between baseline (≤ 28 days before ESA initiation) and response determination date (Hb assessment closest to day 56). Non-responders were further classified as continuers or discontinuers based on the presence of ESA treatment following determination of non-response. ESA use, adverse events, and costs were assessed using Chi-square test for comparisons. Results: A total of 1,198 patients were classified as non-responders (591 in pre-2007 and 607 in post-2007). ESA continuation rate was lower for post-2007 compared to pre-2007 (75% vs. 90%, p < 0.0001). Conclusions: The percentage of patients continuing ESA treatment in the absence of Hb response has decreased since 2007, yet still remains high despite guideline recommendations. It is not clear from these data whether the increased risks and cost burden in these patients were offset by other positive outcomes. [Table: see text]

scholarly journals Trends in response rate and survival in small-cell lung cancer patients between 1997 and 2017

Lung Cancer ◽  
2019 ◽  
Vol 131 ◽  
pp. 122-127 ◽  
Author(s):  
Mickaël Lattuca-Truc ◽  
Jean-François Timsit ◽  
Matteo Giaj Levra ◽  
Stéphane Ruckly ◽  
Julie Villa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Response Rate ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients

Real-world treatment patterns and survival of BRAF V600-mutated metastatic non-small cell lung cancer patients.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. 9096-9096
Author(s):  
Leora Horn ◽  
Joshua Bauml ◽  
Patrick M. Forde ◽  
Keith L. Davis ◽  
Nathaniel James Myall ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Real World ◽  
Treatment Patterns ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients

The efficacy of immune checkpoint inhibitors and PD-L1 status in patients with advanced non-small cell lung cancer harboring oncogenic driver alterations: Immuno-oncology biomarker study in LC-SCRUM-Japan.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 9046-9046
Author(s):  
Kiyotaka Yoh ◽  
Shingo Matsumoto ◽  
Kei Kunimasa ◽  
Masahiro Kodani ◽  
Koichi Nishi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Response Rate ◽  
Checkpoint Inhibitors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients

9046 Background: The efficacy of immune checkpoint inhibitors (ICI) and PD-L1 status in patients with advanced non-small cell lung cancer (NSCLC) harboring oncogenic alterations has not been fully investigated. We initiated this immuno-oncology biomarker study as part of nationwide genomic screening by LC-SCRUM-Japan (LC-SCRUM-IBIS). Methods: Lung cancer patients enrolled in LC-SCRUM-IBIS underwent targeted next-generation sequencing (NGS) with Oncomine Comprehensive Assay, PD-L1 immunohistochemistry (IHC) assays and further whole-exome sequencing (WES) to determine tumor mutation burden. According to subtype of oncogenic alterations, the efficacy of ICI and PD-L1 status were analyzed. Results: Between Feb 2017 and May 2018, 1017 lung cancer patients were enrolled. Of these, 832 NSCLC patients had adequate tumor samples and were included in this analysis. Targeted NGS showed that major oncogenic alterations included 157 EGFR, 83 KRAS, 33 MET, 30 HER2, 25 FGFR, 22 PIK3CA, 19 ALK, 15 ROS1, 10 RET, 5 BRAF and 13 others. High expression of PD-L1 ( > 50% of tumor cells by 22C3) were observed in RET (70%), MET (67%), ROS1 (53%), KRAS (41%) and BRAF (40%) positive tumors. One-hundred five patients were evaluable for the efficacy of ICI, including 80 non-squamous and 25 squamous histology. Among them, 104 were treated with PD-1/PD-L1 monotherapy and only 1 in combination therapy of ICI. Median treatment line was 2 (range, 1-9). The response rate was 19% (20/105) and median progression-free survival (PFS) and overall survival (OS) were 3.3 and 18.3 months. In 50 patients harboring at least one oncogenic alterations, the response rate, PFS and OS were 18% (9/50), 3.3 and 24.8 months. Among 9 responders to ICI, 3 had KRAS, 2 had MET and 1 each had ALK/EGFR/HER2/RET. Six (26%) of 23 patients with both high PD-L1 expression and at least one oncogenic alterations responded to ICI. Conclusions: PD-L1 status seemed to vary among patients with advanced NSCLC harboring oncogenic alterations. New biomarker for ICI therapy in this population should be moreover explored. Updated results on WES analysis will be presented at the meeting.

scholarly journals Determination of EGFR and KRAS mutational status in Greek non-small-cell lung cancer patients

2015 ◽  
Vol 10 (4) ◽  
pp. 2176-2184 ◽  
Author(s):  
EIRINI PAPADOPOULOU ◽  
NIKOLAOS TSOULOS ◽  
ANGELIKI TSIRIGOTI ◽  
ANGELA APESSOS ◽  
KONSTANTINOS AGIANNITOPOULOS ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
Mutational Status

scholarly journals Real-world outcomes in patients with ALK-positive non-small cell lung cancer treated with crizotinib

2018 ◽  
Vol 25 (1) ◽  
pp. 40 ◽  
Author(s):  
K.L. Davis ◽  
J.A. Kaye ◽  
E.T. Masters ◽  
S. Iyer
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Response Rate ◽  
Objective Response ◽  
The United States ◽  
Treatment Patterns ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Line Therapy

Background Crizotinib has shown greater efficacy in clinical trials than chemotherapy in patients with anaplastic lymphoma kinase-positive (alk+) non-small cell lung cancer (nsclc), but little information is available on its use and outcomes in real-world settings. We therefore assessed treatment patterns and outcomes in alk+ nsclc patients treated with crizotinib in regular clinical practice.Methods A retrospective medical record review was conducted in North America for adults with alk+ nsclc treated with crizotinib as first- or later-line therapy for metastatic disease between 1 August 2011 and 31 March 2013 (for the United States) or 1 May 2012 and 31 March 2013 (for Canada). Crizotinib-related trial enrollees were excluded. Descriptive analyses were conducted to assess treatment patterns and objective response rate (orr). Progression-free survival (pfs) and overall survival (os) were descriptively analyzed using Kaplan-Meier methods.Results Data were extracted for 212 patients in the United States (n = 147) and Canada (n = 65). Mean (standard deviation [sd]) age was 58.9 (9.5) years, and 69% were male. Seventy-nine patients (37%) were deceased at record abstraction. Sixty-five percent (n = 137) initiated crizotinib as first-line therapy. Mean (sd) duration of crizotinib treatment was 8.7 (4.9) months. Objective response rate was 66% (69% for first-line recipients, 60% for second-/laterline). Median (95% ci) pfs and os from crizotinib initiation were 9.5 (8.7, 10.1) and 23.4 (19.5, ‒) months, respectively. One- and two-year survival probabilities were 82% and 49%, respectively.Conclusions Outcomes for crizotinib recipients in this study align with previous trials, with orr appearing more favourable in first-line recipients. Our findings indicate that crizotinib outcomes in clinical studies may translate to regular clinical practice.

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