OBJECTIVES : Endometrial cancer (EC) affects ~55,000 women annually in the United States, but patients with advanced/recurrent EC who progress following platinum therapy have limited treatment options. This analysis assessed real-world treatment patterns and associated costs among these patients.

METHODS : This retrospective analysis used claims data from Truven Health Analytics MarketScan^® US Commercial and Medicare Supplemental Databases from January 2014 through June 2018. Analysis included patients with EC aged >18 years. End of prior platinum therapy was defined as the addition of a new agent >28 days from regimen start, a >60-day treatment gap for initiating non-platinum therapy, or a >183-day gap between platinum claims. Post-platinum therapy initiation (Index) was defined as the date of the first claim for an EC drug after the end of prior platinum therapy. Eligible patients needed continuous insurance coverage for ≥12 months before and ≥1 month after the Index.

RESULTS : 1,562 patients met the inclusion criteria (Commercial, n=1,097; Medicare, n=465), with a median age of 61 years. Median follow-up was 9.9 months post-Index, with median pre-Index coverage of 26.6 months. Overall, 54% of patients received initial platinum–taxane therapy, most commonly carboplatin–paclitaxel (43%).

Post-Index, 663 (42%) patients received monotherapy, including: 15% hormonal therapy, 7% liposomal doxorubicin, 5% bevacizumab, 3% taxane, 2% platinum, and 2% doxorubicin; ≤22 (1%) received any other monotherapy. Other than carboplatin-paclitaxel (23%), ≤50 patients (3%) received any other combination regimen. Median duration of post-platinum treatment was 3.0 months across regimens. Mean total cost of claims was ~$17,000/month during the Index period.

CONCLUSIONS : This study highlights the lack of a uniform standard of care for patients with post-platinum advanced/recurrent EC. Treatment regimens that are currently used in this setting are associated with limited benefit and high cost. Newer, more effective therapies are needed for the treatment of advanced or recurrent endometrial cancer.