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Treatment Patterns by EGFR Mutation Status in Non-Small Cell Lung Cancer Patients in the USA: A Retrospective Database Analysis.
- Source :
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Advances in therapy [Adv Ther] 2018 Nov; Vol. 35 (11), pp. 1905-1919. Date of Electronic Publication: 2018 Oct 19. - Publication Year :
- 2018
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Abstract
- Introduction: Targeted therapies, including tyrosine kinase inhibitors (TKIs) that target the sensitizing epidermal growth factor receptor (EGFR) gene are recommended for patients with non-small cell lung cancer (NSCLC). Most patients with NSCLC who test positive for the EGFR mutation and receive TKIs develop resistance to these drugs. Questions remain regarding which treatment sequence is optimal for patients with EGFR-mutant NSCLC, and few studies have evaluated patterns of TKI treatment use in NSCLC, irrespective of EGFR mutation status, in a real-world setting. This population-based study aimed to evaluate treatment patterns at a national level in the USA.<br />Methods: This retrospective observational study used data from the US Oncology Network's iKnowMed database. Patients with advanced NSCLC who initiated first-line therapy with erlotinib and/or intravenous chemotherapy between January 1, 2012 and June 30, 2015 and met all other study criteria were included. Descriptive analyses assessed demographic and clinical characteristics and treatment patterns among the overall study cohort, as well as for specific erlotinib treatment subgroups, stratified by EGFR status.<br />Results: Among the 3108 patients identified, 18.5% were EGFR positive, 49.8% were EGFR negative, and 31.7% were EGFR documented unknown. For the overall cohort, 18.4% received first-line erlotinib monotherapy, fewer than 1% received first-line combination therapy (erlotinib plus chemotherapy), 4.7% received second-line erlotinib monotherapy, and 3.3% received second-line combination therapy. First-line erlotinib monotherapy was used in 77.8% of all EGFR positive patients. Almost two-thirds of the overall cohort were not observed to have advanced to second-line therapy.<br />Conclusions: As treatment options evolve, this study provides real-world treatment patterns that suggest concordance with NCCN guidelines and confirm the remaining need to understand sequencing of therapies and related outcomes.<br />Funding: Eli Lilly and Company.
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Databases, Factual statistics & numerical data
ErbB Receptors genetics
Female
Humans
Male
Middle Aged
Molecular Targeted Therapy methods
Mutation
Protein Kinase Inhibitors administration & dosage
Protein Kinase Inhibitors adverse effects
Retrospective Studies
Treatment Outcome
United States epidemiology
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung genetics
Carcinoma, Non-Small-Cell Lung pathology
Drug Resistance, Neoplasm genetics
Erlotinib Hydrochloride administration & dosage
Erlotinib Hydrochloride adverse effects
Lung Neoplasms drug therapy
Lung Neoplasms genetics
Lung Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1865-8652
- Volume :
- 35
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Advances in therapy
- Publication Type :
- Academic Journal
- Accession number :
- 30341504
- Full Text :
- https://doi.org/10.1007/s12325-018-0811-0