OBJECTIVES: In Brazil, data on clinical and economic burden of non-small cell lung cancer (NSCLC) are scarce. This study presents real-world data on patient characteristics, treatment patterns and resource use for advanced NSCLC (aNSCLC) patients in Brazilian private institutions.

METHODS: Data from medical charts were collected from six private institutions in Brazil. Eligible patients were ≤18 years old at diagnosis, diagnosed with advanced or recurrent (stages IIIb and IV) NSCLC between January 2011 and July 2014, and had received at least two chemotherapy treatment lines. Data were summarized using descriptive statistics.

RESULTS: Out of 430 charts screened, 152 (non-squamous=121, squamous=26, unknown=5) were eligible. Patients’ median age was 62 years, 55.9% were male, 43.4% were former smokers and 16.4% were smokers. All patients had received two treatment lines, and 57.2% and 31.6% had received three and four treatment lines, respectively. EGFR mutation testing was performed in 116 patients (76.3%), of which 41 (35.5%) were EGFR+. Among the EGFR+ patients, 87.8% received a tyrosine kinase inhibitor (46.3% first-line, 41.5% in other lines). Sixteen and 21 different regimens were used as first- and second-line treatments, respectively. Bevacizumab + carboplatin + paclitaxel (32; 21.1%), carboplatin + pemetrexed (31; 20.4%) and cisplatin + pemetrexed (26; 17.1%) were the most frequent first-line regimens, while docetaxel (36; 23.7%), pemetrexed (26; 17.1%) and carboplatin + pemetrexed (20; 13.2%) were the most common second-line regimens. Regarding resource use, 52%/25% of the patients had hospitalizations/ER visits, 95.4% used supplemental medication (median number of medications 13 [1-85]), and 50% had supplemental procedures (median number of procedures 1 [1-16]).

CONCLUSIONS: Treatment patterns for patients with aNSCLC in this study were highly heterogeneous, suggesting lack of a clear standard-of-care in the pre-immunooncology era. The observed high resource use suggests an important economic burden to the private healthcare system and need for therapies that can reduce resource use.