Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens
Abstract Background Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR TKIs) are established first-line treatments among patients with metastatic non-small cell lung cancer harboring EGFR-sensitizing mutations. Upon EGFR TKI resistance, there are scant data supporting a standard of ca...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2023-09-01
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| Series: | Drugs - Real World Outcomes |
| Online Access: | https://doi.org/10.1007/s40801-023-00383-1 |
| _version_ | 1797376785980063744 |
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| author | Elizabeth Marrett Winghan Jacqueline Kwong Jipan Xie Ameur M. Manceur Selvam R. Sendhil Eric Wu Raluca Ionescu-Ittu Janakiraman Subramanian |
| author_facet | Elizabeth Marrett Winghan Jacqueline Kwong Jipan Xie Ameur M. Manceur Selvam R. Sendhil Eric Wu Raluca Ionescu-Ittu Janakiraman Subramanian |
| author_sort | Elizabeth Marrett |
| collection | DOAJ |
| description | Abstract Background Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR TKIs) are established first-line treatments among patients with metastatic non-small cell lung cancer harboring EGFR-sensitizing mutations. Upon EGFR TKI resistance, there are scant data supporting a standard of care in subsequent lines of therapy. Objective We aimed to characterize real-world treatment patterns and adverse events associated with hospitalization in later lines of therapy. Methods This retrospective analysis of administrative claims included adults with metastatic non-small cell lung cancer who initiated a next line of therapy (index line of therapy) following EGFR TKI and platinum-based chemotherapy discontinuation on/after 1 November, 2015. Treatment regimens and adverse event rates during the index line of therapy were described. Results Among 195 eligible patients (median age: 59 years; female: 60%), the five most common index line of therapy regimens were immune checkpoint inhibitor monotherapy (29%), EGFR TKI monotherapy (21%), platinum-based chemotherapy (19%), non-platinum-chemotherapy (13%), and EGFR TKI combinations (9%). The overall median (95% confidence interval) time to discontinuation of the index line of therapy was 2.8 (2.1–3.2) months. Common adverse events associated with hospitalizations included infection/sepsis, pneumonia/pneumonitis, and anemia (2.9, 2.8, and 2.0 per 100 person-months, respectively). Conclusions Among EGFR TKI-resistant patients who discontinued platinum-based chemotherapy, the duration of the next line of therapy was short, treatment was highly variable, and re-treatment with EGFR TKIs and platinum-based regimens was common, suggesting a lack of standard of care in later lines. Adverse event rates associated with hospitalization were high, especially among platinum-treated patients. These results underscore the unmet need for new therapies in a later line of treatment to reduce the clinical burden among patients in this population. |
| first_indexed | 2024-03-08T19:43:37Z |
| format | Article |
| id | doaj.art-9caad38b62b441cfafd81f36ac1d42c7 |
| institution | Directory Open Access Journal |
| issn | 2199-1154 2198-9788 |
| language | English |
| last_indexed | 2024-03-08T19:43:37Z |
| publishDate | 2023-09-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Drugs - Real World Outcomes |
| spelling | doaj.art-9caad38b62b441cfafd81f36ac1d42c72023-12-24T12:30:25ZengAdis, Springer HealthcareDrugs - Real World Outcomes2199-11542198-97882023-09-0110453154410.1007/s40801-023-00383-1Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy RegimensElizabeth Marrett0Winghan Jacqueline Kwong1Jipan Xie2Ameur M. Manceur3Selvam R. Sendhil4Eric Wu5Raluca Ionescu-Ittu6Janakiraman Subramanian7Health Economics and Outcomes Research, Daiichi Sankyo, Inc.Health Economics and Outcomes Research, Daiichi Sankyo, Inc.Analysis GroupAnalysis GroupAnalysis GroupAnalysis GroupAnalysis GroupInova Schar Cancer InstituteAbstract Background Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR TKIs) are established first-line treatments among patients with metastatic non-small cell lung cancer harboring EGFR-sensitizing mutations. Upon EGFR TKI resistance, there are scant data supporting a standard of care in subsequent lines of therapy. Objective We aimed to characterize real-world treatment patterns and adverse events associated with hospitalization in later lines of therapy. Methods This retrospective analysis of administrative claims included adults with metastatic non-small cell lung cancer who initiated a next line of therapy (index line of therapy) following EGFR TKI and platinum-based chemotherapy discontinuation on/after 1 November, 2015. Treatment regimens and adverse event rates during the index line of therapy were described. Results Among 195 eligible patients (median age: 59 years; female: 60%), the five most common index line of therapy regimens were immune checkpoint inhibitor monotherapy (29%), EGFR TKI monotherapy (21%), platinum-based chemotherapy (19%), non-platinum-chemotherapy (13%), and EGFR TKI combinations (9%). The overall median (95% confidence interval) time to discontinuation of the index line of therapy was 2.8 (2.1–3.2) months. Common adverse events associated with hospitalizations included infection/sepsis, pneumonia/pneumonitis, and anemia (2.9, 2.8, and 2.0 per 100 person-months, respectively). Conclusions Among EGFR TKI-resistant patients who discontinued platinum-based chemotherapy, the duration of the next line of therapy was short, treatment was highly variable, and re-treatment with EGFR TKIs and platinum-based regimens was common, suggesting a lack of standard of care in later lines. Adverse event rates associated with hospitalization were high, especially among platinum-treated patients. These results underscore the unmet need for new therapies in a later line of treatment to reduce the clinical burden among patients in this population.https://doi.org/10.1007/s40801-023-00383-1 |
| spellingShingle | Elizabeth Marrett Winghan Jacqueline Kwong Jipan Xie Ameur M. Manceur Selvam R. Sendhil Eric Wu Raluca Ionescu-Ittu Janakiraman Subramanian Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens Drugs - Real World Outcomes |
| title | Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens |
| title_full | Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens |
| title_fullStr | Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens |
| title_full_unstemmed | Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens |
| title_short | Treatment Patterns and Adverse Event-Related Hospitalization Among Patients with Epidermal Growth Factor Receptor (EGFR)-Mutated Metastatic Non-small Cell Lung Cancer After Treatment with EGFR Tyrosine Kinase Inhibitor and Platinum-Based Chemotherapy Regimens |
| title_sort | treatment patterns and adverse event related hospitalization among patients with epidermal growth factor receptor egfr mutated metastatic non small cell lung cancer after treatment with egfr tyrosine kinase inhibitor and platinum based chemotherapy regimens |
| url | https://doi.org/10.1007/s40801-023-00383-1 |
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