Search

International audience; Objectives: To describe the impact of immune checkpoint inhibitors (ICIs) on treatment patterns and survival outcomes in patients with locally advanced or metastatic non-small cell lung cancer (aNSCLC) in France and Germany. Materials and Methods: Patients with aNSCLC without known ALK or EGFR mutations receiving first-line (1L) therapy were included from (i) the retrospective Epidemiological-Strategy and Medical Economics Advanced and Metastatic Lung Cancer cohort (ESME-AMLC, France; 2015–2018) and (ii) the prospective Clinical Research platform Into molecular testing, treatment and outcome of non-Small cell lung carcinoma Patients platform (CRISP, Germany; 2016–2018). Analyses were stratified according to histology. Survival outcomes were estimated using Kaplan–Meier methodology and stratified by year of 1L therapy. Data sources were analysed separately. Results: In ESME-AMLC and CRISP, 8,046 and 2,359 patients were included in the study, respectively. In both countries, approximately 20 % of all patients received pembrolizumab monotherapy as 1L treatment in 2018. In ESME-AMLC, the proportion receiving an ICI over the course of treatment (any line) increased from 42.2 % (2015) to 56.1 % (2018) in patients with squamous histology, and 28.9 % to 51.9 % with non-squamous/other; in CRISP, it increased from 50.6 % (2016) to 65.2 % (2018) with squamous histology, and 40.8 % to 62.7 % with non-squamous/other. Two-year overall survival from 1L initiation was 36.8 % and 25.6 % in the squamous cohorts and 36.5 % and 30.8 % in the non-squamous/other cohorts in ESME-AMLC and CRISP, respectively. No significant change in overall survival was observed over time; however, the follow-up time available was limited in the later years of the analysis. Conclusion: The results of this joint research from two large clinical databases in France and Germany demonstrate the growing use of ICIs in the management of aNSCLC. Future analyses will allow for the evaluation of the impact of ICIs on long-term survival of patients with aNSCLC.

Background Future demographic and economic changes warrant a better understanding of older persons’ need for health-related long-term care services (LTC). LTC uptake among older people is likely to be influenced by the presence or absence of family members, but there is scarce research on the role played by partners with different caregiving potential. There is even less research on the contributions of adult children and their caregiving potential. The current study examines the extent to which transitions into LTC in older men and women differ according to the presence and caregiving potential of partners and children. Methods Linked registry data for Norway on older persons (aged 65+), their partners, and their adult children are used to examine how characteristics of these family members influence transitions into LTC from 2010 to 2016, using logistic discrete-time hazard regression models. We observed around 215,000 transitions to LTC, corresponding to around 26.3% of individuals and 5.4% of the total person-years (4.0 million). Caregiving potential is measured in terms of employment, income, health and educational attainment for partners and education and geographical proximity for children. Results Personal, partner and child(ren)’s resources are all associated with older persons’ LTC uptake. Unpartnered and/or childless older people are more likely to use LTC than those with partners and/or child(ren). Older persons with resourceful partners and children are the least likely to transition into LTC. The geographical proximity of adult children appears to have only a minor influence on LTC use among older people. Conclusions Population ageing and strained public resources will likely challenge the future provision of formal old-age care. The role of family networks in the future provision of formal old-age care is expected to become progressively important in the years to come. Inequalities in the health, care and welfare of older persons with and without resourceful family members are likely to increase.

Period life expectancy at birth (PLE0) is defined as how long – on average – a newborn baby could expect to live if current mortality rates do not change. It is one of the most widely used population health indicators in the world by academics, governments, statistical agencies, and international organisations. Yet, while estimates of PLE0 routinely factor immigrations and emigrations into population denominators and migrant residents form part of these population denominators, the effect of the unique mortality of international migrants on national PLE0 has almost never been studied. Here, our aim is to understand whether estimates and comparisons of national PLE0 in four Nordic nations – Denmark, Finland, Norway, and Sweden – are being affected by the mortality of their international migrant populations. We use register data for over three decades, from 1990 to 2019. We calculate PLE0 by sex for entire resident, native-born, and migrant populations, as well as the differences between them. Our analysis reveals a dynamic and increasing impact of the mortality of international migrants on national PLE0 that is already beginning to affect inter-country comparisons and rankings of mortality. Our unique findings should resonate strongly in all nations with substantial shares of international migrants and all of the aforementioned stakeholders that use PLE0 to drive and inform public health policy.