REAL-WORLD PATIENT CHARACTERISTICS, TREATMENT PATTERNS, AND SURVIVAL AMONG LOCALLY-ADVANCED/METASTATIC ALK+ NON-SMALL CELL LUNG CANCER PATIENTS IN LATIN AMERICA

Author(s)

Arrieta O1, Mascheroni MB2, Recondo G3, Kaen D4, Zhang J5, Patel D6, Swallow E7, Balu S5, Camacho OC8, Ratto B9, Kageleiry A7, Stein K5, Degun R10, Martin C11
1Instituto Nacional de Cancerologia, Mexico City, Mexico, 2Sanatorio Nosiglia, Posadas, Argentina, 3CEMIC Institute, Buenos Aires, Argentina, 4Centro Oncologico Riojano Integral (CORI), La Rioja, Argentina, 5Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 6Navigant Consulting, Inc., London, UK, 7Analysis Group, Inc., Boston, MA, USA, 8Novartis Farmaceutica, S.A.de C.V., Ciudad de Mexico, NJ, USA, 9Novartis Argentina S.A., Buenos Aires, Argentina, 10Navigant Consulting Inc., London, UK, 11Fleming Institute, Buenos Aires, Argentina

OBJECTIVES: To describe patient characteristics, treatment patterns, and survival among Latin American patients diagnosed with locally-advanced/metastatic ALK+ non-small cell lung cancer (NSCLC). METHODS: Mexican and Argentine oncologists (N=5) reviewed patient charts and reported characteristics, treatment patterns, and survival on their patients diagnosed with ALK+ locally-advanced/metastatic NSCLC. Treatment duration and overall survival (OS) were estimated using Kaplan-Meier analyses. RESULTS: Patients (N=25) averaged 57 years old when diagnosed with locally-advanced/metastatic NSCLC; 64% were female, 56% were Hispanic, 44% were Caucasian, 48% were uninsured, and 24% were unemployed or on sick leave. Smoking history varied (36% never-smokers, 20% light/moderate smokers, and 32% heavy smokers). At primary diagnosis, 72% had metastatic disease. Over the course of their disease (until end of follow-up), 48% of patients developed brain metastases, 20% bone, and 32% lung. In first-line therapy, 17 patients (68%) received chemotherapy and six patients (24%) received crizotinib. After first-line chemotherapy, six patients (24%) received crizotinib. 13 patients (52%) never received an ALK inhibitor; of these, nine patients (69%) did not receive crizotinib because they could not afford it or crizotinib was not covered by insurance. Out of the 12 patients who received crizotinib, three died, and eight discontinued by the end of follow-up (median duration of 127 days), with three patients switching to chemotherapy, one to afatinib, and four receiving no further antineoplastic therapy. After diagnosis of locally-advanced/metastatic NSCLC, the OS rate among all patients was 74% at 12 months. CONCLUSIONS: Though the sample size is small, the study provides the first analysis of patient characteristics, treatment patterns, and survival among ALK+ NSCLC patients in Latin America. Many patients were women, uninsured, never received an ALK inhibitor, and their OS was low. These findings suggest that there could be an unmet need for access to effective treatments for ALK+ NSCLC patients in Latin America.

Conference/Value in Health Info

2015-09, ISPOR Latin America 2015, Santiago, Chile

Value in Health, Vol. 18, No. 7 (November 2015)

Code

PCN9

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes, Safety & Pharmacoepidemiology

Disease

Oncology, Rare and Orphan Diseases

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