Author(s)
Kothari S1, Arunachalam A2, Tsao M3, Lee DH4, Kambartel K5, Isobe H6, Huang M7, Escosteguy Barrios CH8, Khattak A9, de Marinis F10, Cao X11, Burke T12, Lopez MA13, De Castro J14
1Merck & Co, Kenilworth, NJ, USA, 2Merck & Co., Inc., North Wales, PA, USA, 3University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada, 4Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea, Republic of (South), 5Bethanien Hospital, Moers, Germany, 6KKR Sapporo Medical Center, Sapporo, Japan, 7Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan, 8PUCRS School of Medicine, Porto Alegre, Brazil, 9FIona Stanley Hospital, Murdoch, Australia, 10European Institute of Oncology, Milan, Italy, 11Merck & Co, Inc, Kenilworth, NJ, USA, 12Merck & Co., Inc., Lebanon, NJ, USA, 13MSD, Madrid, Spain, 14Hospital Universitario La Paz, MADRID, Spain
OBJECTIVES: This study characterized Bmx testing, treatment patterns and overall survival (OS) among advanced NSCLC patients. METHODS: This chart review study, conducted in Italy, Spain, Germany, Australia, Japan, Korea, Taiwan, and Brazil, included 1440 newly diagnosed NSCLC patients (stage IIIB/IV) initiating systemic therapy from 01/Jan/2011-01/July/2013, with follow-up until July-2016. Treatment patterns and survival were evaluated by histology, line of therapy and receipt of a Bmx test (EGFR mutation (EGFR-m)/ ALK rearrangements (ALK-r) ever (yes/no) & by mutation status for tested patients (EGFR-m/ALK-r positive/EGFR-m/ALK-r negative/unknown). Country specific data were analyzed descriptively and presented as ranges (lowest – highest country). Overall survival (OS) from start of first line (1L) was estimated using Kaplan Meier method. RESULTS: Overall, patients with ≥ 1 Bmx test varied from 43% (Brazil) - 85% (Taiwan). Numerically, mostly females with stage-IV non-squamous NSCLC (NSQ), Asians, never/former-smokers received a test. Testing was common in NSQ (54% (Brazil)-91% (Taiwan)). Among NSQ patients, the percentages of positive EGFR-m and ALK-r tests ranged from 17% (Brazil)–67% (Taiwan) and 0% (Brazil)-60% (Taiwan) respectively. NSQ patients with positive EGFR-m/ ALK-r status receiving a 1L targeted therapy ranged from 30% (Germany) to 89% (Japan). Platinum-based combinations (PBC) were used as 1LT for 88% (Japan) to 98% (Brazil) NSQ tested patients with negative/inconclusive test results. Among untested patients, majority in 1L received PBC 80% (Italy) - 98% (Spain) except in Taiwan, where 41% received single agents. Median OS from start of 1L ranged from 10 (Japan) to 26.7 (Taiwan) months for tested and 7.6 (Australia/Brazil) to 19.3 (Taiwan) months for untested patients. CONCLUSIONS: Results suggests that patients with advanced NSCLC were commonly tested for molecular biomarkers at the time of the study and received targeted therapy according to their mutation status. Survival outcomes of patients receiving targeted therapy were comparable to published literature.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
CN4
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Oncology
