EVOLUTION OF THE PROFILE AND DURATION OF ONCOLOGICAL TREATMENT IN LUNG CANCER IN THE ONCOLOGY PHARMACY UNIT
Author(s)
JUAN FRANCISCO MARIN POZO, Pharm D, PhD, TORRECILLA ABRIL MANUEL ANGEL, Pharm D, MARIN CABA ALBERTO, Physics Degree, MORENO BANEGAS JOSE, Pharm D, ABENZA GUARDIOLA ASTRID, Pharm D, DOMINGO ADRADOS ADRIAN, Pharm D.
HOSPITAL UNIVERSITARIO DE JAEN, JAEN, Spain.
HOSPITAL UNIVERSITARIO DE JAEN, JAEN, Spain.
OBJECTIVES: To describe the evolution of the pharmacological profile and duration of systemic oncological treatment in lung cancer (NSCLC and SCLC) within an Oncology Pharmacy Unit and to analize the impact of the introduction of immunotherapy and tyrosine kinase inhibitors (TKIs) on healthcare activity and treatment duration.
METHODS: Retrospective observational study analyzing all records of intravenous (IV) chemotherapy administrations (2005-2024) and oral oncology dispensations (2012-2024) for lung cancer patients. Main variables included: number of administrations or dispensations per year and active ingredient, pharmacological classification (chemotherapy, immunotherapy, TKI), and patient-level treatment duration (interval between first and last recorded administration, in months).
RESULTS: A total of 46,190 IV administrations (2,341 patients) and 12,050 oral dispensations (1,142 patients) were analyzed. IV immunotherapy grew from 0% in 2015 to 37.4% of all active administrations in 2024, reaching 43.1% in NSCLC by 2022 (pembrolizumab dominant) and 27% in SCLC by 2023-2024 (atezolizumab-led). Median IV treatment duration increased from 3.4 months (2005-2007) to 4.3 months (2020-2024), peaking at 6.2 months for patients initiating treatment in 2021. In oral oncology, vinorelbine dominated dispensations (41.6% of total), but TKI generational shifts were evident: osimertinib surpassed erlotinib andgefitinib from 2020, and alectinib consolidated over crizotinib from 2018. After excluding oral chemotherapy (vinorelbine, etoposide), the global median TKI duration rose from 2.25 to 3.91 months. Individual drug medians reached 26.8 months for alectinib (n=23), 14.0 months for gefitinib (n=31), 13.2 months for osimertinib (n=36), and 12.5 months for dabrafenib (n=26), compared to only 2.1 months for vinorelbine (n=615).
CONCLUSIONS: The integration of immunotherapy and TKIs has transformed lung cancer treatment, with increased treatment duration and convergence between IV maintenance immunotherapy and oral TKI durations. Oral conventional chemotherapy acts as a statistical diluent masking longer TKI outcomes. These findings are relevant for resource planning in oncology pharmacy units.
METHODS: Retrospective observational study analyzing all records of intravenous (IV) chemotherapy administrations (2005-2024) and oral oncology dispensations (2012-2024) for lung cancer patients. Main variables included: number of administrations or dispensations per year and active ingredient, pharmacological classification (chemotherapy, immunotherapy, TKI), and patient-level treatment duration (interval between first and last recorded administration, in months).
RESULTS: A total of 46,190 IV administrations (2,341 patients) and 12,050 oral dispensations (1,142 patients) were analyzed. IV immunotherapy grew from 0% in 2015 to 37.4% of all active administrations in 2024, reaching 43.1% in NSCLC by 2022 (pembrolizumab dominant) and 27% in SCLC by 2023-2024 (atezolizumab-led). Median IV treatment duration increased from 3.4 months (2005-2007) to 4.3 months (2020-2024), peaking at 6.2 months for patients initiating treatment in 2021. In oral oncology, vinorelbine dominated dispensations (41.6% of total), but TKI generational shifts were evident: osimertinib surpassed erlotinib andgefitinib from 2020, and alectinib consolidated over crizotinib from 2018. After excluding oral chemotherapy (vinorelbine, etoposide), the global median TKI duration rose from 2.25 to 3.91 months. Individual drug medians reached 26.8 months for alectinib (n=23), 14.0 months for gefitinib (n=31), 13.2 months for osimertinib (n=36), and 12.5 months for dabrafenib (n=26), compared to only 2.1 months for vinorelbine (n=615).
CONCLUSIONS: The integration of immunotherapy and TKIs has transformed lung cancer treatment, with increased treatment duration and convergence between IV maintenance immunotherapy and oral TKI durations. Oral conventional chemotherapy acts as a statistical diluent masking longer TKI outcomes. These findings are relevant for resource planning in oncology pharmacy units.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD130
Topic
Clinical Outcomes, Organizational Practices, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Oncology