scholarly journals Treatment Patterns, Clinical Outcomes and Healthcare Costs of Advanced Non-Small Cell Lung Cancer: A Real-World Evaluation in Italy

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3809
Author(s):  
Matteo Franchi ◽  
Diego Cortinovis ◽  
Giovanni Corrao
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Real World ◽  
Healthcare Costs ◽  
Small Cell ◽  
Line Treatment ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Treatment

We aimed at describing treatment pathways, clinical outcomes and healthcare costs of advanced non-small cell lung cancer (NSCLC) patients in Lombardy Region, Italy. Using healthcare administrative data, 37,562 patients with a new diagnosis of lung cancer between 2012 and 2019 were identified. Among these, patients who started a first-line treatment for advanced NSCLC with either pembrolizumab (n = 660) or tyrosine-kinase inhibitors (TKI) (n = 1245) before 30 June 2020 were included in the study cohort and followed-up until 31 December 2020. Among pembrolizumab users, median time-to-treatment failure (TTF) and median overall survival (OS) were 3.2 months and 13.6 months, respectively. About one third (34.1%) switched to second-line treatment (chemotherapy for all of them). Among TKI users, median TTF and median OS were 9.3 months and 18.4 months, respectively, and 37.1% of patients started second-line treatment (17.8% with TKI and 19.2% with chemotherapy). Average per-patient cumulative healthcare costs during the first year after first-line treatment start were 51,735 € and 30,708 €, respectively, in pembrolizumab and TKI first-line users. These results are coherent with those reported from other real--world studies and may help both clinicians and health decision makers.

A real-world analysis of non-small cell lung cancer patients treated with pembrolizumab or pembrolizumab in combination with pemetrexed and platinum.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 53-53
Author(s):  
Himani Agg ◽  
Katherine B. Winfree ◽  
Yajun Emily Zhu ◽  
Catherine Muehlenbein
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Real World ◽  
Patient Characteristics ◽  
Small Cell ◽  
Line Treatment ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Treatment

53 Background: Pembrolizumab (Pembro) is used in first-line treatment of patients with metastatic non-squamous non-small cell lung cancer (NSQ NSCLC) as monotherapy and in combination with pemetrexed and platinum agent (Pembro+Pem+Plat). Pembro monotherapy is approved for patients whose tumors express PD-L1 Tumor Proportion Score (TPS) ≥ 1% while triplet therapy is approved regardless of PD-L1 TPS. These 2 regimens have not been compared in a head-to-head trial, and real world (RW) treatment pattern data are lacking. This study used RW data to describe patients who received Pembro or Pembro+Pem+Plat and associated overall survival (OS). Methods: This retrospective observational study selected adult patients with diagnosis of advanced NSQ NSCLC who started first-line treatment with Pembro or Pembro+Pem+Plat between Mar. 2015- Aug. 2018 in Flatiron Health’s electronic health record-derived database. Patient characteristics were summarized descriptively, and the Kaplan-Meier survival method was used (unadjusted). Results: A total of 1137 patients received Pembro (median age 72 years) and 1068 patients received Pembro+Pem+Plat (median age 67 years). Patient characteristics are shown in the Table. Median OS was 11.9 months for the Pembro cohort and 14.3 months for the Pembro+Pem+Plat cohort. Median OS by PD-L1 TPS was TPS < 1%: 8.8 months for Pembro and 9.5 months for Pembro+Pem+Plat, TPS 1-49%: 8.9 months for Pembro and not reached (NR) for Pembro+Pem+Plat, and TPS ≥50%: 13.4 months for Pembro and NR for Pembro+Pem+Plat. Conclusions: These RW data seem to suggest baseline differences between the population with Pembro and Pembro+Pem+Plat with regard to age, PS, disease stage, as well as PD-L1 status. Those baseline differences may play a role in the clinicians’ choice of the two treatment options for the NSCLC patients. [Table: see text]

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