ADVANCED SOFT TISSUE SARCOMA- SYSTEMIC TREATMENT PATTERNS AND SURVIVAL IN GERMANY

Author(s)

Mytelka DS1, Lorenzo M2, Stafkey-Mailey D3, D'Yachkova Y4, Nagar SP5, Candrilli SD5, Kaye JA6, Kasper B7
1Eli Lilly, Indianapolis, IN, USA, 2Eli Lilly and Company Limited, Windlesham, UK, 3Xcenda, LLC, Palm Harbor, FL, USA, 4Eli Lilly Austria GmbH, Vienna, Austria, 5RTI Health Solutions, Research Triangle Park, NC, USA, 6RTI Health Solutions, Waltham, MA, USA, 7Mannheim University Medical Center, Mannheim, Germany

OBJECTIVES:  Characterize real-world treatment patterns and survival in Germany for patients with advanced soft tissue sarcoma (STS) not amenable to surgery or radiotherapy. METHODS:  German physicians completed a web-based medical record review for patients ≥18 years old who had received ≥1 line of systemic therapy for advanced STS (other than Kaposi's sarcoma or gastrointestinal stromal tumors) between 1/1/2005 and 20/2/2014. Physicians reported patients’ clinical characteristics, treatments and outcomes. Data were summarized overall, by line of therapy, and for histological subtypes. RESULTS:  Forty physicians (primarily practicing in academic hospitals (58%) or cancer centers (28%)) provided data for 204 patients. Physicians reported that 10% (median) of the patients in their practices with advanced STS did not receive any systemic cancer-directed therapy and were thus ineligible for this study. Patients' mean age at advanced STS diagnosis was 57.4 (SD=11.0) years, and 64% were male. The most frequent histologic subtypes were leiomyosarcoma (32%), liposarcoma (11%), and rhabdomyosarcoma (10%). Seventy-seven percent of patients had stage IV STS at initial diagnosis; the remainder progressed in an average of 23 (SD=23) months. Forty percent of patients had >1 and 6% had >2 lines of therapy. The five most frequent first-line chemotherapy regimens were doxorubicin (53%), doxorubicin/ifosfamide/mesna (17%), docetaxel/gemcitabine (13%), paclitaxel (4%), and dacarbazine/ifosfamide/mesna (3%); in second-line they were ifosfamide/mesna (41%), docetaxel/gemcitabine (20%), pazopanib (15%), doxorubicin (9%), and trabectedin (5%). During first-line treatment, response rate was an average of 39%, with the highest rate for patients receiving dacarbazine/ifosfamide/mesna (50%; N=6) and the lowest rate for paclitaxel users (13%; N=8). Median survival estimates from start of first- and second-line therapy were 13 (Q1:Q3=8:31) and 19 (Q1:Q3=11: Q3 not estimable) months, respectively. CONCLUSIONS:  Results from this retrospective medical record review point to modest differentiation among existing therapies and a need for further improvements in advanced STS treatment options in Germany.

Conference/Value in Health Info

2016-10, ISPOR Europe 2016, Vienna, Austria

Value in Health, Vol. 19, No. 7 (November 2016)

Code

PCN286

Topic

Epidemiology & Public Health, Health Service Delivery & Process of Care

Topic Subcategory

Health Care Research, Public Health, Treatment Patterns and Guidelines

Disease

Oncology

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