CLINICAL OUTCOMES AND ECONOMIC BURDEN FOLLOWING TREATMENT FOR UNRESECTABLE OR METASTATIC ESOPHAGEAL CANCER
Author(s)
Syed Zia Khan, PharmD, BCSCP1, Abhimanyu Roy, BS Pharm, MBA2, Joseph Gricar, MS3, Nicole M. Engel-Nitz, PhD, MS2, Lin Zhan, MS4, Hoa Pham, PharmD4, Mary DuCharme, MLIS2, Lee Ding, PharmD4.
1South Texas Oncology Hematology, San Antonio, TX, USA, 2Optum Life Sciences, Eden Prairie, MN, USA, 3Snell Medical Communication, Montreal, QC, Canada, 4BeOne Medicines, Ltd, San Carlos, CA, USA.
1South Texas Oncology Hematology, San Antonio, TX, USA, 2Optum Life Sciences, Eden Prairie, MN, USA, 3Snell Medical Communication, Montreal, QC, Canada, 4BeOne Medicines, Ltd, San Carlos, CA, USA.
OBJECTIVES: Advanced unresectable/metastatic esophageal cancer (EC) remains a malignancy with high-mortality and limited effective treatment options. To address the ongoing need for real-world evidence to improve patient management, this study aimed to examine treatment patterns, adverse events (AE), and survival in patients diagnosed with advanced unresectable/metastatic EC, as well as the associated economic impact.
METHODS: Adult patients initiating EC therapy from January 2018-March 2024 were identified in the Optum Research Database. Administrative medical and pharmacy claims were used to examine patient demographics, clinical characteristics, treatment patterns, and clinical outcomes. AEs were identified using ICD-9/10-CM and NDC codes. Kaplan-Meier (KM) survival curves were used to estimate median overall survival (OS). All-cause and EC-related utilization and costs were also examined.
RESULTS: The population included 1,393 1L and 458 2L patients. Most were ≥65 years of age (75.7%), non-Hispanic white (77.2%). Notably, 1,158 (45.4%) of patients met the inclusion criteria were untreated. Only 50.0% received biomarker testing at baseline, despite ~89.0% having evidence of testing by baseline or follow- up. Twelve‑month OS was poor, 39-55% in 1L and 42-58% in 2L, with heterogeneity across regimens. AEs occurred in 69.1% (1L) and 73.6% (2L) of patients; common AEs included anemia, dehydration, nausea, neutropenia, thrombocytopenia, and neuropathy. All‑cause PPPM costs rose sharply with treatment, increasing from $3,654 baseline to $13,182 during 1L and $12,663 during 2L, primarily driven by ambulatory services.
CONCLUSIONS: The results highlight a substantial unmet need in advanced unresectable/metastatic EC. Nearly half of patients remained untreated; those treated faced high toxicity, limited survival, and significant costs. The poor outcomes and high burden underscore the need to optimize timely biomarker testing and ensure appropriate use of immunotherapy and other innovative therapies.
METHODS: Adult patients initiating EC therapy from January 2018-March 2024 were identified in the Optum Research Database. Administrative medical and pharmacy claims were used to examine patient demographics, clinical characteristics, treatment patterns, and clinical outcomes. AEs were identified using ICD-9/10-CM and NDC codes. Kaplan-Meier (KM) survival curves were used to estimate median overall survival (OS). All-cause and EC-related utilization and costs were also examined.
RESULTS: The population included 1,393 1L and 458 2L patients. Most were ≥65 years of age (75.7%), non-Hispanic white (77.2%). Notably, 1,158 (45.4%) of patients met the inclusion criteria were untreated. Only 50.0% received biomarker testing at baseline, despite ~89.0% having evidence of testing by baseline or follow- up. Twelve‑month OS was poor, 39-55% in 1L and 42-58% in 2L, with heterogeneity across regimens. AEs occurred in 69.1% (1L) and 73.6% (2L) of patients; common AEs included anemia, dehydration, nausea, neutropenia, thrombocytopenia, and neuropathy. All‑cause PPPM costs rose sharply with treatment, increasing from $3,654 baseline to $13,182 during 1L and $12,663 during 2L, primarily driven by ambulatory services.
CONCLUSIONS: The results highlight a substantial unmet need in advanced unresectable/metastatic EC. Nearly half of patients remained untreated; those treated faced high toxicity, limited survival, and significant costs. The poor outcomes and high burden underscore the need to optimize timely biomarker testing and ensure appropriate use of immunotherapy and other innovative therapies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD20
Topic
Real World Data & Information Systems
Disease
SDC: Oncology