REAL-WORLD TREATMENT PATTERNS, OUTCOMES, HCRU AND COSTS ASSOCIATED WITH PREVIOUSLY-TREATED EXTENSIVE-STAGE SCLC IN THE US FOLLOWING THE APPROVAL OF NEWER TREATMENT OPTIONS
Author(s)
Melissa L. Santorelli, PhD, MPH1, Hozefa A. Divan, PhD, MSPH2, Xiaoxia Wang, PharmD, MSc3, Adriana Valderrama, MBA, PhD4, Himani Aggarwal, MPhil, PhD4, Marian Eberl, MSc5, Jie Meng, MIHMEP5, Ivan Radujko, MHA6, Noura J. Choudhury, MD7;
1Merck & Co., Inc., Principal Scientist, Rahway, NJ, USA, 2Merck & Co., Inc., Boston, MA, USA, 3Merck & Co., Inc., West Point, PA, USA, 4Merck & Co., Inc., Rahway, NJ, USA, 5Daiichi Sankyo Europe GmbH, Munich, Germany, 6Daiichi Sankyo, Basking Ridge, NJ, USA, 7University of Chicago, Department of Medicine, Chicago, IL, USA
1Merck & Co., Inc., Principal Scientist, Rahway, NJ, USA, 2Merck & Co., Inc., Boston, MA, USA, 3Merck & Co., Inc., West Point, PA, USA, 4Merck & Co., Inc., Rahway, NJ, USA, 5Daiichi Sankyo Europe GmbH, Munich, Germany, 6Daiichi Sankyo, Basking Ridge, NJ, USA, 7University of Chicago, Department of Medicine, Chicago, IL, USA
OBJECTIVES: Extensive-stage small cell lung cancer (ES-SCLC) is highly aggressive, with most patients relapsing shortly after response to front-line therapy. Recent FDA approvals of lurbinectedin (2020) and tarlatamab (2024) provide new treatment options for previously-treated patients. We aimed to describe current treatment patterns, health care resource use (HCRU), and costs to characterize economic burden and unmet needs.
METHODS: We conducted a retrospective cohort study using Optum’s® de-identified Clinformatics® Data Mart database. A treatment-based algorithm identified previously-treated patients with ES SCLC who received second-line (2L) and third-line (3L) therapies after tarlatamab approval (May 16, 2024). Patients were followed until earliest of death, disenrollment, or data cut-off (June 30, 2025). Treatment patterns, patient characteristics, HCRU and direct costs were described. Outcomes were reported for patients whose index date allowed ≥6 months of potential follow-up.
RESULTS: A total of 264 and 92 patients received 2L and 3L therapy, respectively; 53% and 60.9% female; mean age 70.1 and 68.6 years. In 2L, lurbinectedin (44.7%), carboplatin + etoposide + atezolizumab (10.2%), and tarlatamab (9.8%) were most common. In 3L, lurbinectedin and tarlatamab were most common (28.3% each), followed by nivolumab or pembrolizumab (5.4% each). Median (Q1-Q3) standardized cost per patient-week was $6,514 ($3,679-$9,954) in 2L and $4,597 ($2,961-$7,447) in 3L. Inpatient costs were lower in 3L vs. 2L: $1,523 ($813-$3,806) vs. $2,146 ($895-$3,965); likewise for outpatient costs $3,854 ($2,430-$5,696) vs. $4,851 ($2,936-$7,797). Median follow-up was 4.8 months in both 2L (n=156) and 3L (n=46) cohorts. During follow-up, 28.9% (2L) and 13.0% (3L) of patients received a subsequent line; 57.1% (2L) and 65.2% (3L) died.
CONCLUSIONS: Early real-world data post-tarlatamab approval show high costs and mortality. In addition, fragmented 2L/3L treatment highlights the need for novel therapies that improve clinical and economic outcomes.
METHODS: We conducted a retrospective cohort study using Optum’s® de-identified Clinformatics® Data Mart database. A treatment-based algorithm identified previously-treated patients with ES SCLC who received second-line (2L) and third-line (3L) therapies after tarlatamab approval (May 16, 2024). Patients were followed until earliest of death, disenrollment, or data cut-off (June 30, 2025). Treatment patterns, patient characteristics, HCRU and direct costs were described. Outcomes were reported for patients whose index date allowed ≥6 months of potential follow-up.
RESULTS: A total of 264 and 92 patients received 2L and 3L therapy, respectively; 53% and 60.9% female; mean age 70.1 and 68.6 years. In 2L, lurbinectedin (44.7%), carboplatin + etoposide + atezolizumab (10.2%), and tarlatamab (9.8%) were most common. In 3L, lurbinectedin and tarlatamab were most common (28.3% each), followed by nivolumab or pembrolizumab (5.4% each). Median (Q1-Q3) standardized cost per patient-week was $6,514 ($3,679-$9,954) in 2L and $4,597 ($2,961-$7,447) in 3L. Inpatient costs were lower in 3L vs. 2L: $1,523 ($813-$3,806) vs. $2,146 ($895-$3,965); likewise for outpatient costs $3,854 ($2,430-$5,696) vs. $4,851 ($2,936-$7,797). Median follow-up was 4.8 months in both 2L (n=156) and 3L (n=46) cohorts. During follow-up, 28.9% (2L) and 13.0% (3L) of patients received a subsequent line; 57.1% (2L) and 65.2% (3L) died.
CONCLUSIONS: Early real-world data post-tarlatamab approval show high costs and mortality. In addition, fragmented 2L/3L treatment highlights the need for novel therapies that improve clinical and economic outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD87
Topic
Health Service Delivery & Process of Care
Disease
SDC: Oncology